Healthcare Provider Details

I. General information

NPI: 1184379190
Provider Name (Legal Business Name): JAVIER OLIVAS JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2022
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 N ANDERSON RD
EXETER CA
93221-9674
US

IV. Provider business mailing address

8307 BRIMHALL RD. UNIT 1705
BAKERSFIELD CA
93312
US

V. Phone/Fax

Practice location:
  • Phone: 559-594-4855
  • Fax:
Mailing address:
  • Phone: 888-585-7373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: