MS. ADRIENNE HOLLINGSWORTH
NPI 1215316351
Student in an Organized Health Care Education/Training Program in Fullerton, CA

Active since May 21, 2015Opted out of Medicare · through Jan 4, 2028
2050 YOUTH WAY, FULLERTON, CA 92835(714) 871-9264 Get Directions Write a Review

NPPES record last updated: May 21, 2015. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Ms. Adrienne Hollingsworth NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. ADRIENNE HOLLINGSWORTH (NPI 1215316351) is an individual student in an organized health care education/training program in Fullerton, California and active in the NPI registry since May 2015. She has opted out of Medicare through January 4, 2028.

NPPES Registry Identity

NPI1215316351
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameMS. ADRIENNE HOLLINGSWORTH
Location Address2050 YOUTH WAYFullerton, CA 92835-3819
Mailing Address111 W Avenida Palizada, Unit 8, Ste 77San Clemente, CA 92672-4763 · (978) 973-2817
Sole ProprietorYes
Enumeration DateMay 21, 2015
NPI 1215316351 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

2050 YOUTH WAY, Fullerton, CA 92835

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Ms. Adrienne Hollingsworth has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 4, 2024 through January 4, 2028.

Opt-Out Effective DateJanuary 4, 2024
Opt-Out In Effect ThroughJanuary 4, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Marriage & Family Therapist
2050 YOUTH WAY
FULLERTON, CA 92835
Marriage & Family Therapist
2050 YOUTH WAY
FULLERTON, CA 92835
Marriage & Family Therapist
2050 YOUTH WAY
FULLERTON, CA 92835
Psychologist (Clinical Child & Adolescent)
2050 YOUTH WAY, BLDG. #1
FULLERTON, CA 92835
Counselor (Mental Health)
2050 YOUTH WAY
FULLERTON, CA 92835
Counselor (Mental Health)
2050 YOUTH WAY
FULLERTON, CA 92835
Clinical Neuropsychologist
2050 YOUTH WAY
FULLERTON, CA 92835
Marriage & Family Therapist
2050 YOUTH WAY
FULLERTON, CA 92835

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1215316351, enumerated as an "individual" on May 21, 2015.

The provider is located at 2050 YOUTH WAY FULLERTON, CA 92835 and the phone number is (714) 871-9264.

Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.