Provider Demographics
NPI:1245985464
Name:OLSSON, SAVANNA PAIGE (PMHNP)
Entity type:Individual
Prefix:MRS
First Name:SAVANNA
Middle Name:PAIGE
Last Name:OLSSON
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:SAVANNA
Other - Middle Name:PAIGE
Other - Last Name:HILLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11283 YUCCA DR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-2253
Mailing Address - Country:US
Mailing Address - Phone:720-219-1650
Mailing Address - Fax:
Practice Address - Street 1:15434 W SAGE ST
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92392-9751
Practice Address - Country:US
Practice Address - Phone:909-653-2515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-16
Last Update Date:2023-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95020033363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health