Provider Demographics
NPI:1912554965
Name:OLSSON, NATALIE BLUE (LMFT)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:BLUE
Last Name:OLSSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13402 HUDSON LN
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-5690
Mailing Address - Country:US
Mailing Address - Phone:407-733-6124
Mailing Address - Fax:
Practice Address - Street 1:13402 HUDSON LN
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-5690
Practice Address - Country:US
Practice Address - Phone:407-733-6124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-23
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA114541106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist