Provider Demographics
NPI:1619005097
Name:OLIVER, JOAN B (MS)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:B
Last Name:OLIVER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 MCCONNELL AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-7026
Mailing Address - Country:US
Mailing Address - Phone:310-482-5614
Mailing Address - Fax:310-482-5570
Practice Address - Street 1:5300 MCCONNELL AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-7026
Practice Address - Country:US
Practice Address - Phone:310-482-5614
Practice Address - Fax:310-482-5570
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS