Basic Information
| Provider Information | |||||||||
| NPI: | 1659422533 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OLIVA | ||||||||
| FirstName: | ARCELI | ||||||||
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| Credential: | ANP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 17981 SKY PARK CIR | ||||||||
| Address2: | BLDG, 39, STE. B | ||||||||
| City: | IRVINE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926146348 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8778967350 | ||||||||
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| Practice Location | |||||||||
| Address1: | 17981 SKY PARK CIR STE B | ||||||||
| Address2: | |||||||||
| City: | IRVINE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926146349 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197823456 | ||||||||
| FaxNumber: | 9197831441 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/16/2007 | ||||||||
| LastUpdateDate: | 04/19/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 5005215 | NC | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 363LP0808X | 95002599 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.