Provider Demographics
NPI:1154727659
Name:INTEGRATIVE HOLISTIC PSYCHOLOGY
Entity type:Organization
Organization Name:INTEGRATIVE HOLISTIC PSYCHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MARRIAGE FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:HELEN
Authorized Official - Last Name:STAHLHOFEN
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:949-351-4091
Mailing Address - Street 1:630 S GLASSELL ST STE 100F
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866-3082
Mailing Address - Country:US
Mailing Address - Phone:949-351-4091
Mailing Address - Fax:
Practice Address - Street 1:630 S GLASSELL ST STE 100F
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-3082
Practice Address - Country:US
Practice Address - Phone:949-351-4091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-10
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 35670106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty