Provider Demographics
NPI:1275033748
Name:OLSON, ANDREW (RBT)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:
Last Name:OLSON
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5132 N PALM AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-2236
Mailing Address - Country:US
Mailing Address - Phone:559-492-7900
Mailing Address - Fax:559-570-0222
Practice Address - Street 1:1630 E SHAW AVE STE 190
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710
Practice Address - Country:US
Practice Address - Phone:559-475-7860
Practice Address - Fax:559-570-0222
Is Sole Proprietor?:No
Enumeration Date:2018-02-20
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-20-43833103K00000X
CARBT-17-44014106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician