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General NPI Number Information
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NPI Number | 1235419029
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Entity Type | Individual
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Provider Name | KATHRYN OLSON PSYD
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Gender | Female
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Dates
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Enumeration Date | 08/24/2011
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Last Update Date | 12/13/2021
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Provider Practice Location Address
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Address Line | 5405 MOREHOUSE DR STE 330
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City | SAN DIEGO
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State | CA
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Zip | 92121-4786
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Country | US
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Telephone | 858-284-1550
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Fax | 858-284-1660
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Provider Business Mailing Address
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Address Line | 4231 BALBOA AVE # 211
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City | SAN DIEGO
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State | CA
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Zip | 92117-5504
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Country | US
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Telephone | 619-719-1348
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY25951
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License Number State | CA
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