Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | ||
Y | 103T00000X | Psychologist |
NPI | 1013262658 |
---|---|
Provider Name | Olivia Rold |
First Address | Roseville, CA 95661-7781 |
Second Address | Roseville, CA 95661-7781 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2012 |
Last Update Date | 12/07/2021 |