Individual
MRS. EVELINA A. OLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1620 SWALLOW WAY, HERCULES, CA 94547-1648
(510) 915-0158
Mailing address
1620 SWALLOW WAY, HERCULES, CA 94547-1648
(510) 915-0158
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
08426593
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E0701386
DRIVER'S LICENSE
CA
Enumeration date
12/02/2021
Last updated
12/02/2021
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