Provider Demographics
NPI:1962590521
Name:OLSON, PAMELA KAREN (MFT)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:KAREN
Last Name:OLSON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 STANYAN ST APT 4
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-3833
Mailing Address - Country:US
Mailing Address - Phone:415-990-3427
Mailing Address - Fax:415-665-6478
Practice Address - Street 1:4237 GEARY BL
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118
Practice Address - Country:US
Practice Address - Phone:415-990-3427
Practice Address - Fax:415-665-6478
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC39528106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist