MEDICARE: JESSECA LEE HOLSTON M.A., LMFT

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	106H00000X	Marriage & Family Therapist	0717001507	VA
2	106H00000X	Marriage & Family Therapist	95098	CA

General Provider Information

NPI Number	:	1104121342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSECA LEE HOLSTON M.A., LMFT

Provider Business Mailing Address
First Line	:	321 CASSIDY ST
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92054-5314
Country	:	US
Telephone Number	:	760-721-2171
Fax Number	:	760-721-8582

Provider Business Practice Location Address
First Line	:	2501 ALLEGHANY LOOP
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23456-2442
Country	:	US
Telephone Number	:	858-349-0873
Fax Number	:	858-349-0873

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2011
Last Update Date	:	03/01/2020

Similar Medicare Providers

1164673398 — DAVID JONATHAN HARTZELL IDC
Practice Location Address:

2521 ALLEGHANY LOOP
VIRGINIA BEACH, VA
23456-2442

Practice Phone: 240-481-4429
Practice Fax:

1699303677 — PURSUIT COUNSELING
Practice Location Address:

2501 ALLEGHANY LOOP
VIRGINIA BEACH, VA
23456-2442

Practice Phone: 858-349-0873
Practice Fax:

1134816242 — NON-EMERGENCY MEDICAL TRANSPORT LLC
Practice Location Address:

5429 BALFOR DR
VIRGINIA BEACH, VA
23464-2442

Practice Phone: 919-348-3434
Practice Fax:

1821628785 — QUAN MINH LE OT
Practice Location Address:

7915 VIRGINIA ST
ROSEMEAD, CA
91770-2442

Practice Phone: 213-235-5396
Practice Fax:

1912744855 — OLUWAFEMI MAKINDE PT, DPT, MPH
Practice Location Address:

5101 GREENWOOD AVE
WEST PALM BEACH, FL
33407-2442

Practice Phone: 561-842-7588
Practice Fax:

1184698045 — DERMODY PEDIATRIC DENTISTRY & ORTHODONTICS
Practice Location Address:

2000 35TH AVE
VERO BEACH, FL
32960-2442

Practice Phone: 772-562-5150
Practice Fax: 772-562-2711

Directions to “ JESSECA LEE HOLSTON M.A., LMFT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.