Healthcare Provider Details

I. General information

NPI: 1104364546
Provider Name (Legal Business Name): HOLLAND WRENN PAUSELIUS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HOLLY PAUSELIUS

II. Dates (important events)

Enumeration Date: 02/06/2017
Last Update Date: 01/19/2026
Certification Date: 01/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2660 SOLACE PL STE D2
MOUNTAIN VIEW CA
94040-4337
US

IV. Provider business mailing address

PO BOX 361
PALO ALTO CA
94302-0361
US

V. Phone/Fax

Practice location:
  • Phone: 510-566-9029
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number19012
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: