Provider Demographics
NPI:1437443728
Name:OLSEN, LISA ANN (OTD, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:ANN
Last Name:OLSEN
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:MISS
Other - First Name:LISA
Other - Middle Name:ANN
Other - Last Name:ZEUTZIUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:52 WILD HORSE
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92602-0207
Mailing Address - Country:US
Mailing Address - Phone:714-504-8929
Mailing Address - Fax:714-389-0483
Practice Address - Street 1:52 WILD HORSE
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92602-0930
Practice Address - Country:US
Practice Address - Phone:714-504-8929
Practice Address - Fax:714-389-0483
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-03
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1940174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist