Healthcare Provider Details

I. General information

NPI: 1891618047
Provider Name (Legal Business Name): OLIVE COMMUNITY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 E COMMONWEALTH AVE
FULLERTON CA
92832-2017
US

IV. Provider business mailing address

328 E COMMONWEALTH AVE
FULLERTON CA
92832-2017
US

V. Phone/Fax

Practice location:
  • Phone: 714-643-6343
  • Fax: 714-248-8331
Mailing address:
  • Phone: 714-643-6343
  • Fax: 714-248-8331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name: MUHAMMAD TARIQ MUGHAL
Title or Position: CFO
Credential:
Phone: 714-470-9328