Provider Demographics
NPI:1265894091
Name:MASON, HOLADAY (MFT)
Entity type:Individual
Prefix:
First Name:HOLADAY
Middle Name:
Last Name:MASON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9300 WILSHIRE BLVD STE 510
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-3226
Mailing Address - Country:US
Mailing Address - Phone:310-850-2461
Mailing Address - Fax:
Practice Address - Street 1:9300 WILSHIRE BLVD STE 510
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-3226
Practice Address - Country:US
Practice Address - Phone:310-850-2461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT31549106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist