Provider Demographics
NPI:1194233460
Name:OLIVAREZ, JENNIFER E (BA)
Entity type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:E
Last Name:OLIVAREZ
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 BELLE MILL RD
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-2850
Mailing Address - Country:US
Mailing Address - Phone:530-840-2000
Mailing Address - Fax:
Practice Address - Street 1:118 BELLE MILL RD
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-2850
Practice Address - Country:US
Practice Address - Phone:530-840-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-19
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist