Provider Demographics
NPI:1700176351
Name:OLIVIER, GLENDA J (PHD)
Entity Type:Individual
Prefix:DR
First Name:GLENDA
Middle Name:J
Last Name:OLIVIER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:GLENDA
Other - Middle Name:J
Other - Last Name:OLIVIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 863
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92018-0863
Mailing Address - Country:US
Mailing Address - Phone:858-243-1300
Mailing Address - Fax:
Practice Address - Street 1:10650 SCRIPPS RANCH BLVD
Practice Address - Street 2:STE 131
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-2470
Practice Address - Country:US
Practice Address - Phone:858-243-1300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-17
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 17106103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist