Healthcare Provider Details

I. General information

NPI: 1558891556
Provider Name (Legal Business Name): HOLLY EYNON ROLFE MA, RADT, CADC II
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2017
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1560 CAPALINA RD
SAN MARCOS CA
92069-1288
US

IV. Provider business mailing address

365 S RANCHO SANTA FE RD STE 100
SAN MARCOS CA
92078-2338
US

V. Phone/Fax

Practice location:
  • Phone: 760-744-2104
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberA063880224
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: