Provider Demographics
NPI:1801089982
Name:OLEA, MARIBEL
Entity type:Individual
Prefix:
First Name:MARIBEL
Middle Name:
Last Name:OLEA
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 1:3230 WINTER WAY
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93637-5974
Mailing Address - Country:US
Mailing Address - Phone:559-474-3230
Mailing Address - Fax:
Practice Address - Street 1:885 W 18TH ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-4604
Practice Address - Country:US
Practice Address - Phone:209-726-3090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No103TE1100XBehavioral Health & Social Service ProvidersPsychologistExercise & Sports
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAXXXXXXMedicare UPIN