Healthcare Provider Details

I. General information

NPI: 1164516886
Provider Name (Legal Business Name): THOMAS CHRISTOPHER OLONA PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 11/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N BRAND BLVD SUITE 603
GLENDALE CA
91203-2641
US

IV. Provider business mailing address

100 N BRAND BLVD SUITE 603
GLENDALE CA
91203-2641
US

V. Phone/Fax

Practice location:
  • Phone: 818-476-0117
  • Fax:
Mailing address:
  • Phone: 818-476-0117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY 14944
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: