Provider Demographics
NPI:1659068880
Name:OLIVARES, ANAIS BELLE
Entity Type:Individual
Prefix:
First Name:ANAIS
Middle Name:BELLE
Last Name:OLIVARES
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 1:818 OJAI RD
Mailing Address - Street 2:
Mailing Address - City:SANTA PAULA
Mailing Address - State:CA
Mailing Address - Zip Code:93060-1418
Mailing Address - Country:US
Mailing Address - Phone:805-701-2814
Mailing Address - Fax:
Practice Address - Street 1:818 OJAI RD
Practice Address - Street 2:
Practice Address - City:SANTA PAULA
Practice Address - State:CA
Practice Address - Zip Code:93060-1418
Practice Address - Country:US
Practice Address - Phone:805-701-2814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program