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General NPI Number Information
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NPI Number | 1841746880
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Entity Type | Organization
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Legal Business Name | MONICA OLIVEROS
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Dates
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Enumeration Date | 08/30/2016
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Last Update Date | 08/30/2016
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Provider Practice Location Address
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Address Line | 1831 PLAZA PALO ALTO
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City | CHULA VISTA
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State | CA
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Zip | 91914-4622
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Country | US
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Telephone | 619-339-4143
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Fax |
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Provider Business Mailing Address
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Address Line | 1831 PLAZA PALO ALTO
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City | CHULA VISTA
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State | CA
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Zip | 91914-4622
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Country | US
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Telephone | 619-339-4143
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Fax |
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Authorized Official
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Title or Position | REGISTERED NURSE
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Name | MONICA L OLIVEROS
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Credential | RN
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Telephone | 619-339-4143
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 557025
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License Number State | CA
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