Provider Demographics
NPI:1972919322
Name:OLIVEROS, ADRIANA (DPT)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:
Last Name:OLIVEROS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 NORMA ST
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-2710
Mailing Address - Country:US
Mailing Address - Phone:805-869-1718
Mailing Address - Fax:805-477-3979
Practice Address - Street 1:2001 NORMA ST
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2710
Practice Address - Country:US
Practice Address - Phone:805-869-1718
Practice Address - Fax:805-477-3979
Is Sole Proprietor?:No
Enumeration Date:2014-07-07
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT41835225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA41835OtherSTATE LICENSE
CAW268Medicare PIN