Provider Demographics
NPI:1760889513
Name:BROWN, OLIVIA
Entity Type:Individual
Prefix:DR
First Name:OLIVIA
Middle Name:
Last Name:BROWN
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 1:7442 GREENHAVEN DR APT 169
Mailing Address - Street 2:169
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-5117
Mailing Address - Country:US
Mailing Address - Phone:520-307-3062
Mailing Address - Fax:
Practice Address - Street 1:7442 GREENHAVEN DR APT 169
Practice Address - Street 2:169
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-5117
Practice Address - Country:US
Practice Address - Phone:520-307-3062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-21
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA70732183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist