Provider Demographics
NPI:1902275381
Name:WERNICK, OLIVIA ZIEVE (LCSW)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:ZIEVE
Last Name:WERNICK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 DOUGLAS BLVD STE 225
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-4283
Mailing Address - Country:US
Mailing Address - Phone:916-740-3721
Mailing Address - Fax:916-783-0513
Practice Address - Street 1:3400 DOUGLAS BLVD STE 225
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-4283
Practice Address - Country:US
Practice Address - Phone:916-740-3721
Practice Address - Fax:916-783-0513
Is Sole Proprietor?:No
Enumeration Date:2015-09-16
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW610471141041C0700X
CALCSW927671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical