Basic Information
| Provider Information | |||||||||
| NPI: | 1679913073 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OLVERA | ||||||||
| FirstName: | SYLVIA | ||||||||
| MiddleName: | VANESSA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8880 EARHART AVE | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900454118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3106252704 | ||||||||
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| Practice Location | |||||||||
| Address1: | 127 S SAN VICENTE BLVD | ||||||||
| Address2: | 6TH FLOOR | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900483311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104236472 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2013 | ||||||||
| LastUpdateDate: | 06/09/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | 143017 | CA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.