Provider Demographics
NPI:1306970645
Name:OLLIFF, ALICE (RN,BSN,PHN)
Entity type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:
Last Name:OLLIFF
Suffix:
Gender:F
Credentials:RN,BSN,PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11030 CRYSTAL SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-3110
Mailing Address - Country:US
Mailing Address - Phone:619-569-5969
Mailing Address - Fax:
Practice Address - Street 1:5202 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105-2268
Practice Address - Country:US
Practice Address - Phone:619-229-5409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA403168163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health