Provider Demographics
NPI:1508908500
Name:OLVERA, VERONICA I (PSYD)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:I
Last Name:OLVERA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:226 S BEVERLY DR
Mailing Address - Street 2:SUITE 225
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-3817
Mailing Address - Country:US
Mailing Address - Phone:310-273-4843
Mailing Address - Fax:310-273-5056
Practice Address - Street 1:226 S BEVERLY DR
Practice Address - Street 2:SUITE 225
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-3817
Practice Address - Country:US
Practice Address - Phone:310-273-4843
Practice Address - Fax:310-273-5056
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 23490103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist