Provider Demographics
NPI:1578188280
Name:OLGUIN, PAUL ANTHONY SR
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:ANTHONY
Last Name:OLGUIN
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5269 1/2 HUNTINGTON DR N
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90032-1702
Mailing Address - Country:US
Mailing Address - Phone:323-315-8458
Mailing Address - Fax:
Practice Address - Street 1:515 E 6TH ST FL 9
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90021-1009
Practice Address - Country:US
Practice Address - Phone:323-315-8458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-09
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor