Healthcare Provider Details

I. General information

NPI: 1235569484
Provider Name (Legal Business Name): KATHRINE OLMSTEAD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/24/2013
Last Update Date: 11/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UCSB STUDENT HEALTH 588 BUILDING, M/C 7002
SANTA BARBARA CA
93106-0001
US

IV. Provider business mailing address

UCSB STUDENT HEALTH 588 BUILDING, M/C 7002
SANTA BARBARA CA
93106-0001
US

V. Phone/Fax

Practice location:
  • Phone: 805-893-4794
  • Fax: 805-893-3861
Mailing address:
  • Phone: 805-893-4794
  • Fax: 805-893-3861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1400X
TaxonomyCollege Health Registered Nurse
License Number469509
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: