Healthcare Provider Details

I. General information

NPI: 1215862511
Provider Name (Legal Business Name): OLIVIA DAHL, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23625 HOLMAN HWY
MONTEREY CA
93940-5902
US

IV. Provider business mailing address

1632 CAMDEN AVE APT 201
LOS ANGELES CA
90025-3530
US

V. Phone/Fax

Practice location:
  • Phone: 831-624-5311
  • Fax:
Mailing address:
  • Phone: 434-466-6221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: OLIVIA DAHL
Title or Position: CEO
Credential: MD
Phone: 434-466-6221