Provider Demographics
NPI:1003210311
Name:OLIVEIRA, JOHN EUGENE III
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:EUGENE
Last Name:OLIVEIRA
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 SEQUOIA BLVD
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95376-4349
Mailing Address - Country:US
Mailing Address - Phone:916-847-2026
Mailing Address - Fax:
Practice Address - Street 1:711 SEQUOIA BLVD
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-4349
Practice Address - Country:US
Practice Address - Phone:916-847-2026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-15
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health