Provider Demographics
NPI:1407501356
Name:OLAIZ, AMBER CARIN (AMBER OLAIZ)
Entity Type:Individual
Prefix:MISS
First Name:AMBER
Middle Name:CARIN
Last Name:OLAIZ
Suffix:
Gender:F
Credentials:AMBER OLAIZ
Other - Prefix:MISS
Other - First Name:AMBER
Other - Middle Name:CARIN
Other - Last Name:OLAIZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1620 LOOKOUT DR
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93035-3133
Mailing Address - Country:US
Mailing Address - Phone:805-216-4332
Mailing Address - Fax:
Practice Address - Street 1:1620 LOOKOUT DR
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93035-3133
Practice Address - Country:US
Practice Address - Phone:805-216-4332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA282071164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse