Provider Demographics
NPI:1275672438
Name:ROLOFF, DANA M (MFT)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:M
Last Name:ROLOFF
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1261 3RD AVE STE D
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-3262
Mailing Address - Country:US
Mailing Address - Phone:619-420-5611
Mailing Address - Fax:619-420-5531
Practice Address - Street 1:1261 3RD AVE STE D
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-3262
Practice Address - Country:US
Practice Address - Phone:619-420-5611
Practice Address - Fax:619-420-5531
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38133106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist