Basic Information
| Provider Information | |||||||||
| NPI: | 1457546756 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OLIVARES | ||||||||
| FirstName: | ANA | ||||||||
| MiddleName: | ROXANA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PSY.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3016 W CHARLESTON BLVD | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891021977 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7027902701 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3016 W CHARLESTON BLVD STE 150 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891021964 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7027902701 | ||||||||
| FaxNumber: | 7027902707 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/10/2007 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | PY0785 | NV | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.