Provider Demographics
NPI:1841746880
Name:MONICA OLIVEROS
Entity Type:Organization
Organization Name:MONICA OLIVEROS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:L
Authorized Official - Last Name:OLIVEROS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:619-339-4143
Mailing Address - Street 1:1831 PLAZA PALO ALTO
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91914-4622
Mailing Address - Country:US
Mailing Address - Phone:619-339-4143
Mailing Address - Fax:
Practice Address - Street 1:1831 PLAZA PALO ALTO
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914-4622
Practice Address - Country:US
Practice Address - Phone:619-339-4143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-30
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA557025261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service