Healthcare Provider Details

I. General information

NPI: 1457256497
Provider Name (Legal Business Name): OLGA TERAN PENLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

537 RALSTON ST
RENO NV
89503-4434
US

IV. Provider business mailing address

255 N SIERRA ST UNIT 2216
RENO NV
89501-1352
US

V. Phone/Fax

Practice location:
  • Phone: 775-298-6386
  • Fax:
Mailing address:
  • Phone: 775-997-8527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberIC-3093
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: