Provider Demographics
NPI:1841831039
Name:OLIVARES, ANGELA (CADC-II)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:OLIVARES
Suffix:
Gender:F
Credentials:CADC-II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1865 HOTEL CIR S
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3319
Mailing Address - Country:US
Mailing Address - Phone:619-673-8116
Mailing Address - Fax:
Practice Address - Street 1:1865 HOTEL CIR S
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3319
Practice Address - Country:US
Practice Address - Phone:619-673-8116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-30
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program