Provider Demographics
NPI:1922991694
Name:WHOLE HOLISTIC CARE
Entity type:Organization
Organization Name:WHOLE HOLISTIC CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JUANA
Authorized Official - Middle Name:L
Authorized Official - Last Name:PORRAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-818-4667
Mailing Address - Street 1:17930 HERCULES ST
Mailing Address - Street 2:
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92345-5454
Mailing Address - Country:US
Mailing Address - Phone:818-818-4667
Mailing Address - Fax:
Practice Address - Street 1:12401 HESPERIA RD STE 4
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-5844
Practice Address - Country:US
Practice Address - Phone:818-818-4667
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty