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General NPI Number Information
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NPI Number | 1720378748
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Entity Type | Individual
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Provider Name | KAITLYN OLSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/11/2011
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Last Update Date | 11/29/2021
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Provider Practice Location Address
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Address Line | 400 W PUEBLO ST
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City | SANTA BARBARA
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State | CA
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Zip | 93105-4353
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Country | US
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Telephone | 805-682-7111
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Fax |
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Provider Business Mailing Address
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Address Line | 400 W PUEBLO ST
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City | SANTA BARBARA
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State | CA
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Zip | 93105-4353
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Country | US
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Telephone |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A124864
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 036.137588
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License Number State | IL
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