Provider Demographics
NPI:1265405401
Name:OLSON, JULIE DEBRA (NP)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:DEBRA
Last Name:OLSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 JEFFERSON ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-2357
Mailing Address - Country:US
Mailing Address - Phone:760-729-8600
Mailing Address - Fax:760-729-2319
Practice Address - Street 1:2910 JEFFERSON ST STE 100
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-2357
Practice Address - Country:US
Practice Address - Phone:760-729-8600
Practice Address - Fax:760-729-2319
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12670363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner