Provider Demographics
NPI:1386116861
Name:OLIVER, VERONICA A
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:A
Last Name:OLIVER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VERONICA
Other - Middle Name:
Other - Last Name:CEVALLOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4434 JUANITA CT
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-3907
Mailing Address - Country:US
Mailing Address - Phone:909-638-8263
Mailing Address - Fax:
Practice Address - Street 1:4434 JUANITA CT
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-3907
Practice Address - Country:US
Practice Address - Phone:909-638-8263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-21
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst