Provider Demographics
NPI:1407311210
Name:OLIVAS, ANA YANCI
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:YANCI
Last Name:OLIVAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24706 SW 109TH PL
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-4613
Mailing Address - Country:US
Mailing Address - Phone:786-284-2464
Mailing Address - Fax:
Practice Address - Street 1:24706 SW 109TH PL
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-4613
Practice Address - Country:US
Practice Address - Phone:786-284-2464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-06
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-22-61867103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst