Provider Demographics
NPI:1407920192
Name:OLAIVAR, ELLEN SCHMIDT (NP BSN MSN)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:SCHMIDT
Last Name:OLAIVAR
Suffix:
Gender:F
Credentials:NP BSN MSN
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:
Other - Last Name:OLAIVAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:7050 W 85TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-2625
Mailing Address - Country:US
Mailing Address - Phone:310-641-0443
Mailing Address - Fax:
Practice Address - Street 1:1124 W CARSON ST # N28
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2006
Practice Address - Country:US
Practice Address - Phone:310-641-0443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6509363LW0102X
CA459956163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse