Provider Demographics
NPI:1609171479
Name:NAVARRO, OLIVIA JAMILE
Entity Type:Individual
Prefix:MISS
First Name:OLIVIA
Middle Name:JAMILE
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2107 BEECHTREE CT
Mailing Address - Street 2:
Mailing Address - City:MENTONE
Mailing Address - State:CA
Mailing Address - Zip Code:92359-1603
Mailing Address - Country:US
Mailing Address - Phone:909-725-1413
Mailing Address - Fax:
Practice Address - Street 1:2107 BEECHTREE CT
Practice Address - Street 2:
Practice Address - City:MENTONE
Practice Address - State:CA
Practice Address - Zip Code:92359-1603
Practice Address - Country:US
Practice Address - Phone:909-725-1413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-25
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health