Healthcare Provider Details

I. General information

NPI: 1508701897
Provider Name (Legal Business Name): THE OLIVE HOUSE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1527 JUANITA ST
NAPA CA
94559-4310
US

IV. Provider business mailing address

1527 JUANITA ST
NAPA CA
94559-4310
US

V. Phone/Fax

Practice location:
  • Phone: 661-476-7190
  • Fax:
Mailing address:
  • Phone: 661-476-7190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: XIOMARA MELISSSA ROBLES
Title or Position: OWNER
Credential: OTR/L
Phone: 661-476-7190