Healthcare Provider Details

I. General information

NPI: 1790649523
Provider Name (Legal Business Name): BRITNEY ALANA OLSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4447 COWELL BLVD APT 75
DAVIS CA
95618-6022
US

IV. Provider business mailing address

4447 COWELL BLVD APT 75
DAVIS CA
95618-6022
US

V. Phone/Fax

Practice location:
  • Phone: 650-207-8992
  • Fax:
Mailing address:
  • Phone: 650-207-8992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86330373
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: