Provider Demographics
NPI:1578345609
Name:FOY-CLAYCOMB, OLIVIA (RN)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:FOY-CLAYCOMB
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 SHADELANDS DR
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2494
Mailing Address - Country:US
Mailing Address - Phone:925-979-4031
Mailing Address - Fax:925-979-4014
Practice Address - Street 1:2401 SHADELANDS DR
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2494
Practice Address - Country:US
Practice Address - Phone:925-979-4031
Practice Address - Fax:925-979-4014
Is Sole Proprietor?:No
Enumeration Date:2023-10-13
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95155482163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse