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General NPI Number Information
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NPI Number | 1093488421
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Entity Type | Individual
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Provider Name | RUSSELL JACOB OLSON
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Gender | Male
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Dates
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Enumeration Date | 07/30/2021
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 175 OMAR WAY
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City | SAN FRANCISCO
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State | CA
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Zip | 94127-1701
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Country | US
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Telephone | 415-469-4734
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Fax |
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Provider Business Mailing Address
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Address Line | 1515 QUINTARA ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94116-1273
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number |
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License Number State |
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