Healthcare Provider Details

I. General information

NPI: 1922462167
Provider Name (Legal Business Name): EVE BUTERA HOLWELL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2016
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3252 HOLIDAY CT STE 201
LA JOLLA CA
92037-1808
US

IV. Provider business mailing address

3252 HOLIDAY CT STE 201
LA JOLLA CA
92037-1808
US

V. Phone/Fax

Practice location:
  • Phone: 858-299-2507
  • Fax:
Mailing address:
  • Phone: 858-299-2507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA169437
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: