Provider Demographics
NPI:1255077897
Name:OLEKSON, TERRI LYNNE
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:LYNNE
Last Name:OLEKSON
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 1:6800 INDIANA AVE STE 260
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-4287
Mailing Address - Country:US
Mailing Address - Phone:951-782-0040
Mailing Address - Fax:
Practice Address - Street 1:1145 BLAZEWOOD ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-5908
Practice Address - Country:US
Practice Address - Phone:951-232-3727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-06
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator