Organization
LISA OLIVO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA MARIE OLIVO (COUNSELOR)
(909) 561-8899
Entity
Organization
Contact information
Practice address
117 E HARRY BRIDGES BLVD, WILMINGTON, CA 90744-5825
(310) 549-8383
(310) 549-9305
Mailing address
1009 ASHPORT ST, POMONA, CA 91768-2323
(909) 561-8899
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Enumeration date
11/05/2007
Last updated
11/05/2007
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