MEDICARE: HOLLY ALLEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	143739	CA

General Provider Information

NPI Number	:	1780008565
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLY ALLEN

Provider Business Mailing Address
First Line	:	1515 PALM AVE
Second Line	:	SUITE A
City	:	IMPERIAL BEACH
State	:	CA
Zip	:	92154
Country	:	US
Telephone Number	:	619-429-4117
Fax Number	:	619-429-4166

Provider Business Practice Location Address
First Line	:	1515 PALM AVE
Second Line	:	SUITE A
City	:	SAN DIEGO
State	:	CA
Zip	:	92154-1011
Country	:	US
Telephone Number	:	619-429-4117
Fax Number	:	619-429-4166

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2014
Last Update Date	:	02/13/2014

Similar Medicare Providers

1023210820 — MS. NATALIA RIVAS CADDE
Practice Location Address:

1515 PALM AVE
SAN DIEGO, CA
92154-1011

Practice Phone: 629-429-4117
Practice Fax:

1083816524 — MS. STEPHANIE DE LA ROSA
Practice Location Address:

1515 PALM AVE , SUITE A
SAN DIEGO, CA
92154-1011

Practice Phone: 619-429-4117
Practice Fax: 619-429-4116

1073624193 — JOSE ANGEL CHAVEZ BA
Practice Location Address:

1011 CAMINO DEL RIO S STE 300
SAN DIEGO, CA
92108-3567

Practice Phone: 619-287-8225
Practice Fax: 619-393-0386

1275661134 — MENTAL HEALTH SYSTEMS, INC.
Practice Location Address:

1011 CAMINO DEL RIO S STE 300
SAN DIEGO, CA
92108-3567

Practice Phone: 619-287-8225
Practice Fax:

1952579419 — WORKWAY NURSING, CORP
Practice Location Address:

1011 CAMINO DEL RIO S , 340
SAN DIEGO, CA
92108-3531

Practice Phone: 619-278-0016
Practice Fax: 877-777-3597

1154599520 — MR. RADGIE TABLADA REGISTERED NURSE
Practice Location Address:

1011 CAMINO DEL RIO S , SUITE 340
SAN DIEGO, CA
92108-3531

Practice Phone: 619-278-0016
Practice Fax: 877-777-3597

Directions to “ HOLLY ALLEN ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.