Healthcare Provider Details

I. General information

NPI: 1104572007
Provider Name (Legal Business Name): SIMONE EVERETT HOLLAND CNM, MSN, WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SIMONE EVERETT TOLMIE CNM

II. Dates (important events)

Enumeration Date: 03/01/2022
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

823 GATEWAY CENTER WAY
SAN DIEGO CA
92102-4541
US

IV. Provider business mailing address

823 GATEWAY CENTER WAY
SAN DIEGO CA
92102-4541
US

V. Phone/Fax

Practice location:
  • Phone: 619-515-2300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number236263
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WP1700X
TaxonomyPerinatal Registered Nurse
License Number95269796
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: