Provider Demographics
NPI:1639501000
Name:ST. HOLLAND, ELIZABETH JEAN (CADAC II)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:JEAN
Last Name:ST. HOLLAND
Suffix:
Gender:F
Credentials:CADAC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3230 WARING CT STE A
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-4509
Mailing Address - Country:US
Mailing Address - Phone:760-305-7528
Mailing Address - Fax:760-509-4410
Practice Address - Street 1:3230 WARING CT STE A
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-4509
Practice Address - Country:US
Practice Address - Phone:760-305-7528
Practice Address - Fax:760-305-7528
Is Sole Proprietor?:No
Enumeration Date:2013-08-07
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CAA022850516101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)