# 2020 VISION YOUTH

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750147120
- **Authorized official:** CORY HOLLAMAN (CHIEF EXCUTIVE OFFICER)
- **Authorized official phone:** (909) 486-8690

## Contact information

- **Practice address:** 14241 FIRESTONE BLVD STE 225, LA MIRADA, CA 90638-5533
- **Practice address phone:** (213) 691-2522
- **Mailing address:** 967 KENDALL DR STE 332, SAN BERNARDINO, CA 92407-4306

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | — | NULL | — |
| 163W00000X | Registered Nurse | — | — | — |
| 171400000X | Health & Wellness Coach | — | NULL | Yes |
| 171400000X | Health & Wellness Coach | — | — | Yes |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | — |
| 171M00000X | Case Manager/Care Coordinator | — | — | — |
| 172V00000X | Community Health Worker | — | NULL | — |
| 172V00000X | Community Health Worker | — | — | — |

## Other

- **Enumeration date:** 02/23/2024
- **Last updated:** 02/28/2026