MEDICARE: DR. AKIRA OLSEN PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	23573	CA
2	103TC0700X	Clinical Psychologist	23573	CA
3	102L00000X	Psychoanalyst
4	103T00000X	Psychologist	23573	CA

General Provider Information

NPI Number	:	1093910184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AKIRA OLSEN PSY.D.

Provider Business Mailing Address
First Line	:	1720 EL CAMINO REAL STE 140
Second Line	:
City	:	BURLINGAME
State	:	CA
Zip	:	94010-3231
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1720 EL CAMINO REAL STE 140
Second Line	:
City	:	BURLINGAME
State	:	CA
Zip	:	94010-3231
Country	:	US
Telephone Number	:	925-282-1778
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2007
Last Update Date	:	10/18/2024

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