Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 158193 | CA |
NPI | 1215461991 |
---|---|
Provider Name | Princella Olalo |
First Address | Sacramento, CA 95817-2201 |
Second Address | Sacramento, CA 95817-2201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2017 |
Last Update Date | 19/11/2021 |