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General NPI Number Information
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NPI Number | 1245919703
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Entity Type | Individual
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Provider Name | ROBYN LOUISE OLSEN
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Gender | Female
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Dates
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Enumeration Date | 07/12/2023
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Last Update Date | 07/12/2023
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Provider Practice Location Address
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Address Line | 1 BOARDWALK AVE STE 210
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-5766
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Country | US
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Telephone | 818-457-1411
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Fax |
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Provider Business Mailing Address
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Address Line | 223 ERBES RD APT 106
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City | THOUSAND OAKS
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State | CA
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Zip | 91362-2716
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Country | US
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Telephone | 818-585-9609
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 140332
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License Number State | CA
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