Provider Demographics
NPI:1083936983
Name:HASTINGS GINES, HOLLY DIANA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:DIANA
Last Name:HASTINGS GINES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:105 N ROSE ST
Mailing Address - Street 2:STE. 211
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92027-7222
Mailing Address - Country:US
Mailing Address - Phone:760-705-8468
Mailing Address - Fax:760-735-2922
Practice Address - Street 1:135 E 3RD AVE
Practice Address - Street 2:STE. B
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4252
Practice Address - Country:US
Practice Address - Phone:760-705-8468
Practice Address - Fax:760-735-2922
Is Sole Proprietor?:No
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS205601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical