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General NPI Number Information
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NPI Number | 1528112380
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Entity Type | Organization
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Legal Business Name | UCDAVIS MEDICAL CENTER
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1627 OAK AVE
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City | DAVIS
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State | CA
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Zip | 95616-1072
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Country | US
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Telephone | 530-400-3544
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Fax |
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Provider Business Mailing Address
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Address Line | 2718 CUMBERLAND PL
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City | DAVIS
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State | CA
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Zip | 95616-2909
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Country | US
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Telephone | 530-400-3544
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | MS. JANET MARY OLESON
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Credential | MSW, LCSW
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Telephone | 15304003544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS# 16490
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License Number State | CA
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