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General NPI Number Information
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NPI Number | 1942955935
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Entity Type | Organization
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Legal Business Name | SAVANNA OLSSON, PMHNP: A PROFESSIONAL NURSING CORPORATION
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Dates
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Enumeration Date | 02/17/2022
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Last Update Date | 02/17/2022
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Provider Practice Location Address
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Address Line | 15434 W SAGE ST
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City | VICTORVILLE
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State | CA
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Zip | 92392-9751
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Country | US
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Telephone | 760-843-0506
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Fax |
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Provider Business Mailing Address
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Address Line | 11283 YUCCA DR
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City | RIVERSIDE
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State | CA
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Zip | 92505-2253
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Country | US
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Telephone | 720-219-1650
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SAVANNA PAIGE OLSSON
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Credential | PMHNP-BC
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Telephone | 720-219-1650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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