Provider Demographics
NPI:1043469695
Name:RUSU, OLIVIA LOANA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:OLIVIA
Middle Name:LOANA
Last Name:RUSU
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17635 ALMOND RD
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-1205
Mailing Address - Country:US
Mailing Address - Phone:510-886-0341
Mailing Address - Fax:
Practice Address - Street 1:17635 ALMOND RD
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-1205
Practice Address - Country:US
Practice Address - Phone:510-886-0341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-18
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18539363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily