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General NPI Number Information
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NPI Number | 1386234581
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Entity Type | Individual
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Provider Name | KRISTIN OLSON ATC
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Gender | Female
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Dates
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Enumeration Date | 01/21/2021
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Last Update Date | 01/21/2021
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Provider Practice Location Address
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Address Line | 4700 COLLEGE OAK DR
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City | SACRAMENTO
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State | CA
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Zip | 95841-4217
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Country | US
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Telephone | 916-412-7707
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Fax |
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Provider Business Mailing Address
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Address Line | 1760 EL CAMINO VERDE DR
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City | LINCOLN
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State | CA
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Zip | 95648-3100
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Country | US
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Telephone | 916-412-7707
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2000029258
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License Number State | CA
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