Provider Demographics
NPI:1427100817
Name:OLSON, HEIDI E (DC)
Entity type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:E
Last Name:OLSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1290 MONUMENT BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-4480
Mailing Address - Country:US
Mailing Address - Phone:925-602-5000
Mailing Address - Fax:925-602-5003
Practice Address - Street 1:1290 MONUMENT BLVD STE B
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-4480
Practice Address - Country:US
Practice Address - Phone:925-602-5000
Practice Address - Fax:925-602-5003
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24542111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU65399Medicare UPIN