Provider Demographics
NPI:1427771385
Name:JUAREZ, OLIVIA CHRISTINA (NP)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:CHRISTINA
Last Name:JUAREZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:OLIVIA
Other - Middle Name:CHRISTINA
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4682 ABBOTSWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-2319
Mailing Address - Country:US
Mailing Address - Phone:619-344-7123
Mailing Address - Fax:
Practice Address - Street 1:4682 ABBOTSWOOD CIR
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-2319
Practice Address - Country:US
Practice Address - Phone:619-344-7123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95053493163W00000X
CA95022469363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse