Individual
LEANNA MARIE OLIVAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1047 SEACOAST DR APT 4, IMPERIAL BEACH, CA 91932-2519
(626) 488-1983
Mailing address
1047 SEACOAST DR APT 4, IMPERIAL BEACH, CA 91932-2519
(626) 488-1983
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F2083176
DRIVER LICENSE
CA
Enumeration date
01/28/2020
Last updated
01/28/2020
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