Provider Demographics
NPI:1669885380
Name:HOLFORD, MARVIN (LCSW)
Entity type:Individual
Prefix:
First Name:MARVIN
Middle Name:
Last Name:HOLFORD
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10331 STANFORD AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92840-6351
Mailing Address - Country:US
Mailing Address - Phone:714-663-6000
Mailing Address - Fax:
Practice Address - Street 1:10331 STANFORD AVE
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-6351
Practice Address - Country:US
Practice Address - Phone:714-663-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-10
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW821821041S0200X, 1041C0700X
NE10270101YM0800X
CA665301041C0700X
NE69261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health