Provider Demographics
NPI:1316336050
Name:OLAES, RIA (COTA)
Entity type:Individual
Prefix:
First Name:RIA
Middle Name:
Last Name:OLAES
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:MISS
Other - First Name:RIA
Other - Middle Name:ALEJO
Other - Last Name:SALVANERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3376 CAMINO MARZAGAN
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92029-7452
Mailing Address - Country:US
Mailing Address - Phone:858-776-9107
Mailing Address - Fax:
Practice Address - Street 1:1260 E OHIO AVE
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92027-3054
Practice Address - Country:US
Practice Address - Phone:760-746-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-19
Last Update Date:2015-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2052224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant