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General NPI Number Information
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NPI Number | 1366999237
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Entity Type | Organization
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Legal Business Name | HOLISTIC PSYCHSOLUTIONS, INC
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Dates
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Enumeration Date | 09/08/2016
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Last Update Date | 09/10/2016
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Provider Practice Location Address
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Address Line | 2945 HARDING ST SUITE 104
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City | CARLSBAD
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State | CA
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Zip | 92008-1818
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Country | US
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Telephone | 760-284-3880
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Fax | 760-284-3881
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Provider Business Mailing Address
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Address Line | 2945 HARDING ST SUITE 104
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City | CARLSBAD
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State | CA
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Zip | 92008-1818
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Country | US
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Telephone | 760-284-3880
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Fax | 760-284-3881
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Authorized Official
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Title or Position | OWNER/LICENSE CLINICAL SOCIAL WORKE
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Name | MS. YVONNE JAZZ IRIZARRY
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Credential | LCSW
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Telephone | 760-284-3880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LCSW71291
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License Number State | CA
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