MEDICARE: LOTUS RISING HOLISTIC THERAPY CENTER A MARRIAGE AND FAMILY THERAPY COMPANY

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

General Provider Information

NPI Number	:	1174159875
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOTUS RISING HOLISTIC THERAPY CENTER A MARRIAGE AND FAMILY THERAPY COMPANY

Provider Business Mailing Address
First Line	:	2386 FARADAY AVE STE 140
Second Line	:
City	:	CARLSBAD
State	:	CA
Zip	:	92008-7222
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2386 FARADAY AVE STE 140
Second Line	:
City	:	CARLSBAD
State	:	CA
Zip	:	92008-7222
Country	:	US
Telephone Number	:	760-496-9394
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JULIE BEDELL MANENTE
Credential	:	LMFT
Telephone Number	:	619-887-3522

Provider Enumeration Date	:	03/14/2020
Last Update Date	:	02/09/2026

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