Provider Demographics
NPI:1861850455
Name:OLIVAREZ, BLANCA
Entity Type:Individual
Prefix:MRS
First Name:BLANCA
Middle Name:
Last Name:OLIVAREZ
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 1:36 QUAIL RUN CIR
Mailing Address - Street 2:BLDG 100 STE S
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93907-2351
Mailing Address - Country:US
Mailing Address - Phone:831-975-4305
Mailing Address - Fax:831-998-8155
Practice Address - Street 1:36 QUAIL RUN CIR
Practice Address - Street 2:BLDG 100 STE S
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93907-2351
Practice Address - Country:US
Practice Address - Phone:831-975-4305
Practice Address - Fax:831-998-8155
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-10
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57097171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter