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NPI Code Detail

MEDICARE: LISA OLSON

MEDICARE: LISA OLSON
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
1106H00000XMarriage & Family Therapist107725CA

General Provider Information

NPI Number : 1912587478
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA OLSON
Provider Business Mailing Address
First Line : 9 CROW CANYON CT STE 100
Second Line :
City : SAN RAMON
State : CA
Zip : 94583-1682
Country : US
Telephone Number : 925-480-7550
Fax Number :
Provider Business Practice Location Address
First Line : 9 CROW CANYON CT STE 100
Second Line :
City : SAN RAMON
State : CA
Zip : 94583-1682
Country : US
Telephone Number : 925-480-7550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2021
Last Update Date : 04/09/2021

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Directions to “ LISA OLSON ” Practice Location

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