Healthcare Provider Details

I. General information

NPI: 1952562639
Provider Name (Legal Business Name): YVONNE JEANETTE OLIVE N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2008
Last Update Date: 06/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11110 ALONDRA BLVD
NORWALK CA
90650-6203
US

IV. Provider business mailing address

11110 ALONDRA BLVD
NORWALK CA
90650-6203
US

V. Phone/Fax

Practice location:
  • Phone: 562-860-2451
  • Fax: 562-467-5076
Mailing address:
  • Phone: 562-860-2451
  • Fax: 562-467-5076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number458011
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: