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General NPI Number Information
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NPI Number | 1124812094
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Entity Type | Organization
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Legal Business Name | HONEST HEALING THERAPEUTIC SERVICES, CORPORATION
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Dates
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Enumeration Date | 04/07/2025
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 38713 TIERRA SUBIDA AVE STE 104
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City | PALMDALE
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State | CA
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Zip | 93551-4562
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Country | US
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Telephone | 661-583-3142
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Fax |
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Provider Business Mailing Address
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Address Line | 38713 TIERRA SUBIDA AVE STE 104
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City | PALMDALE
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State | CA
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Zip | 93551-4562
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Country | US
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Telephone | 661-583-3142
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Fax |
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Authorized Official
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Title or Position | CEO/ FOUNDER
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Name | MRS. SHANETTE MICHELLE IZADI
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Credential | LCSW
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Telephone | 661-583-3142
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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