Provider Demographics
NPI:1912221458
Name:OLESEN, ERIK (MFC)
Entity Type:Individual
Prefix:MR
First Name:ERIK
Middle Name:
Last Name:OLESEN
Suffix:
Gender:M
Credentials:MFC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2941 CHINA WELL RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-9785
Mailing Address - Country:US
Mailing Address - Phone:530-885-2673
Mailing Address - Fax:530-888-0895
Practice Address - Street 1:3288 BELL RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-9243
Practice Address - Country:US
Practice Address - Phone:530-885-2673
Practice Address - Fax:530-888-0895
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 20613106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist