HOLLY FORMAN (NPI# 1487166765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487166765 |
| Entity Type | Individual |
| Full Name | HOLLY FORMAN |
| Credential | LMFT |
| Practice Address |
17121 Tiffany Circle Huntington Beach CA 92649 |
| Mailing Address |
17121 Tiffany Cir Huntington Beach CA 92649-4550 |
| Practice Telephone | 7142930628 |
| Mailing Telephone | 7142930628 |
| Enumeration Date | 2017-10-26 |
| Last Update Date | 2020-02-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 97799 | CA | Behavioral Health & Social Service Providers |
| Street Address |
17121 TIFFANY CIRCLE |
| City | HUNTINGTON BEACH |
| State | CA |
| Zip Code | 92649 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225639305 | Tanisha Grant | Behavioral Analyst | 4592 Warner Ave, Huntington Beach, CA 92649 | 2020-11-04 |
| 1023582772 | Stanley Wayne Combs | Emergency Medicine | 16761 Edgewater Lane, Huntington Beach, CA 92649 | 2019-01-16 |
| 1609382084 | Loc Do | Pharmacist | 16922 Bolsa Chica, Huntington Beach, CA 92649 | 2017-12-20 |
| 1205362522 | Pmh Laboratory Inc | Clinical Medical Laboratory | 5862 Edinger Ave, Huntington Beach, CA 92649 | 2017-05-05 |
| 1972050086 | Clear Reflections Psychol Assocs | Social Worker | 16897 Algonquin St., Ste L, Huntington Beach, CA 92649 | 2016-09-07 |
| 1588011274 | Wisdom Foods Inc | Dietitian, Registered | 16987 Algonquin Street Suite L, Huntington Beach, CA 92649 | 2016-05-23 |
| 1801253398 | Thierry Kolpin | Psychologist | 5202 Edinger, Huntington Beach, CA 92649 | 2016-01-28 |
| 1811374242 | Margarita Bernardo Velarde | Pediatrics | 17392 Wildrose Lane, Huntington Beach, CA 92649 | 2015-05-06 |
| 1023439809 | Orange County Labs Inc. | Clinical Medical Laboratory | 15165 Triton Ln, Huntington Beach, CA 92649 | 2013-12-23 |
| 1205261831 | Turning Pages Recovery, LLC. | Clinic/Center | 5772 Bolsa Ave Suite 210, Huntington Beach, CA 92649 | 2013-09-13 |
| Find all providers in zip 92649 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689291023 | Jessica Ripley | Marriage & Family Therapist | 16052 Beach Blvd Ste 218, Huntington Beach, CA 92647-3809 | 2020-07-01 |
| 1679131668 | Honey Dixit | Marriage & Family Therapist | 18992 Florida Street, Apt No. G6, Huntington Beach, CA 92648 | 2019-06-04 |
| 1033772348 | Insight Children & Family Therapy Inc | Marriage & Family Therapist | 16168 Beach Blvd Ste 215, Huntington Beach, CA 92647-3881 | 2019-04-22 |
| 1619443124 | Christina Minh Mander | Marriage & Family Therapist | 18672 Florida St # 201c, Huntington Beach, CA 92648-1925 | 2018-10-23 |
| 1508361106 | Jennifer Alene Mitzel | Marriage & Family Therapist | 7677 Center Ave Ste 405, Huntington Beach, CA 92647-3098 | 2018-03-26 |
| 1124548276 | Connie Anne Hsu | Marriage & Family Therapist | 18700 Beach Blvd Ste 160, Huntington Beach, CA 92648-2073 | 2017-06-20 |
| 1245776681 | Deborah Lynn Wieland | Marriage & Family Therapist | 17111 Beach Blvd Ste 203, Huntington Beach, CA 92647-5978 | 2017-01-10 |
| 1770025181 | Angela Stcroix | Marriage & Family Therapist | 18672 Florida St Ste 100, Huntington Beach, CA 92648-1925 | 2016-11-16 |
| 1184170698 | Louis David Nealon | Marriage & Family Therapist | 17822 Beach Blvd Ste 230, Huntington Beach, CA 92647-7192 | 2016-08-26 |
| 1982159943 | Anastasia Forjone | Marriage & Family Therapist | 2420 Whitesands Dr Apt 3, Huntington Beach, CA 92648-2850 | 2016-08-19 |
| Find all providers in HUNTINGTON BEACH | ||||
| City | HUNTINGTON BEACH |
| Zip Code | 92649 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.