Provider Demographics
NPI:1487290094
Name:HOLISTIC MENTAL HEALTH
Entity type:Organization
Organization Name:HOLISTIC MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NADIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES-EATON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYCHOLOGIST
Authorized Official - Phone:714-478-4415
Mailing Address - Street 1:61 CANAL
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-2800
Mailing Address - Country:US
Mailing Address - Phone:714-478-4415
Mailing Address - Fax:949-203-2220
Practice Address - Street 1:1801 PARK COURT PL STE F201
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-5031
Practice Address - Country:US
Practice Address - Phone:714-478-4415
Practice Address - Fax:949-203-2220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-19
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty