Healthcare Provider Details

I. General information

NPI: 1255137394
Provider Name (Legal Business Name): CAPITAL SEXUAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2025
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 3RD ST STE 220
DAVIS CA
95616-4547
US

IV. Provider business mailing address

719 2ND ST STE 9
DAVIS CA
95616-4666
US

V. Phone/Fax

Practice location:
  • Phone: 530-564-6338
  • Fax: 833-974-4458
Mailing address:
  • Phone: 530-564-6338
  • Fax: 833-974-4458

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. ELIZABETH CRETTI OLESON
Title or Position: NURSE PRACTITIONER
Credential: NP
Phone: 650-468-3026