Individual
BONNIE J OLSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1520 SAN PABLO ST, 1ST FLOOR, LOS ANGELES, CA 90033-5310
(323) 442-5900
Mailing address
PO BOX 31309, LOS ANGELES, CA 90031-0309
(323) 442-5900
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
WPC15050A
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSY150500
MEDICAL PROVIDER NUMBER
CA
Enumeration date
06/28/2006
Last updated
11/27/2023
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