MEDICARE: HOLISTIC HOME CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1013782572
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLISTIC HOME CARE LLC

Provider Business Mailing Address
First Line	:	4255 PACIFIC AVE STE 3B
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95207-7638
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4122 N EL DORADO ST
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95204-2105
Country	:	US
Telephone Number	:	408-624-2785
Fax Number	:

Authorized Official
Title or Position	:	OWNER, PRESIDENT
Name	:	MARIAN THOMAS
Credential	:
Telephone Number	:	408-624-2785

Provider Enumeration Date	:	11/15/2023
Last Update Date	:	08/27/2025

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