Healthcare Provider Details

I. General information

NPI: 1265315618
Provider Name (Legal Business Name): OLIVIA DEMPSTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2025
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1222 PINE ST STE A
SAINT HELENA CA
94574-1830
US

IV. Provider business mailing address

195 41ST ST UNIT 11321
OAKLAND CA
94611-7012
US

V. Phone/Fax

Practice location:
  • Phone: 866-268-4489
  • Fax: 707-259-1779
Mailing address:
  • Phone: 707-968-7645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95035827
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: