Provider Demographics
NPI:1114234168
Name:OLSON, CHRISTINA LYNNE (SLPA)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LYNNE
Last Name:OLSON
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3556 PREBLE AVE
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-5045
Mailing Address - Country:US
Mailing Address - Phone:619-328-7970
Mailing Address - Fax:
Practice Address - Street 1:1601 EASTMAN AVE
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-6481
Practice Address - Country:US
Practice Address - Phone:805-650-6290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-10
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12932355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant