Provider Demographics
NPI:1932398674
Name:OLSZANOWSKI, MAIELLA GALLEGOS (RN)
Entity Type:Individual
Prefix:MRS
First Name:MAIELLA
Middle Name:GALLEGOS
Last Name:OLSZANOWSKI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 PROVINCETOWN CIR
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93906-4465
Mailing Address - Country:US
Mailing Address - Phone:831-449-8328
Mailing Address - Fax:
Practice Address - Street 1:12 PROVINCETOWN CIR
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906-4465
Practice Address - Country:US
Practice Address - Phone:831-449-8328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-18
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA561623163WP0200X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEPS013360Medicare PIN