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NPI Code Detail

MEDICARE: MRS. CHRISTINE MARIE HOLLIS

MEDICARE: MRS. CHRISTINE MARIE HOLLIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1134249733
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHRISTINE MARIE HOLLIS
Provider Business Mailing Address
First Line : 32173 CAMINO SENECO
Second Line :
City : TEMECULA
State : CA
Zip : 92592-4300
Country : US
Telephone Number : 951-203-4446
Fax Number :
Provider Business Practice Location Address
First Line : 3625 14TH ST
Second Line :
City : RIVERSIDE
State : CA
Zip : 92501-3815
Country : US
Telephone Number : 951-955-1570
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2007
Last Update Date : 08/17/2020

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Directions to “ MRS. CHRISTINE MARIE HOLLIS ” Practice Location

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