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General NPI Number Information
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NPI Number | 1265315618
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Entity Type | Individual
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Provider Name | OLIVIA DEMPSTER
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Gender | Female
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Dates
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Enumeration Date | 07/30/2025
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 1020 HWY 116 S STE 120
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City | SEBASTOPOL
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State | CA
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Zip | 95472-4570
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Country | US
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Telephone | 707-861-0807
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Fax | 707-324-0397
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Provider Business Mailing Address
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Address Line | 195 41ST ST UNIT 11321
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City | OAKLAND
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State | CA
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Zip | 94611-7012
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Country | US
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Telephone | 707-968-7645
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95035827
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License Number State | CA
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