MEDICARE: STEVEN OLIVAREZ

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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1881967206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN OLIVAREZ

Provider Business Mailing Address
First Line	:	730 MEDICAL CENTER CT
Second Line	:
City	:	CHULA VISTA
State	:	CA
Zip	:	91911-6618
Country	:	US
Telephone Number	:	619-397-6933
Fax Number	:

Provider Business Practice Location Address
First Line	:	DEPT LA 22763, PASADENA CA 91185-2763
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91185-6618
Country	:	US
Telephone Number	:	866-523-4268
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2012
Last Update Date	:	06/03/2022

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Directions to “ STEVEN OLIVAREZ ” Practice Location

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