Healthcare Provider Details

I. General information

NPI: 1942144100
Provider Name (Legal Business Name): ANGELA KAY OLSON PPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELA KAY SURGINER PPS

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

298 PATTON PKWY
MARINA CA
93933-6007
US

IV. Provider business mailing address

310 COATES DR
APTOS CA
95003-4307
US

V. Phone/Fax

Practice location:
  • Phone: 831-583-2060
  • Fax:
Mailing address:
  • Phone: 831-645-1261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number210138177
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: