Healthcare Provider Details

I. General information

NPI: 1326446816
Provider Name (Legal Business Name): CHRISTINE ROLLINS LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2014
Last Update Date: 02/14/2022
Certification Date: 02/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4445 EASTGATE MALL STE 200
SAN DIEGO CA
92121-1979
US

IV. Provider business mailing address

4445 EASTGATE MALL STE 200
SAN DIEGO CA
92121-1979
US

V. Phone/Fax

Practice location:
  • Phone: 866-478-3978
  • Fax:
Mailing address:
  • Phone: 866-478-3978
  • Fax: 209-550-4903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT43066
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: