| Provider / Organization | NPI | Date Certified |
|---|---|---|
| KELLY ERIN OLSON | 1669027025 | 2019-08-02 |
Kelly Olson [F] graduated in 2019 and primarily specializes in Physician Assistant.
Kelly Erin Olson is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1669027025. Registration indicates Kelly Erin Olson is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant, ) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (All Other Specialties & Provider Types, ) (Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers)
| PECOS ID | 5597197194 |
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Kelly Erin Olson PA-C |
| Practice Office Address | 2525 ERRINGER RD SIMI VALLEY, CA US |
| Practice Office Telephone | 8055271404 |
| Practice Office Fax | 8055275246 |
| Mailing Address | 5720 RALSTON ST STE 200 VENTURA, CA 930037844 US |
| Business Telephone | 8058044168 |
| Business Fax | 8058301177 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 2230 Lynn Rd Ste 220 | Thousand Oaks, CA 913601985 | 8053794574 / 8053794324 |
| 137 E Thousand Oaks Blvd | Thousand Oaks, CA 913605707 | 8053794574 / 8053794324 |
| CONNECT URL [] | https://venturaortho.com/ | |
| CONNECT URL [] | venturaortho.com |
| Code | Practice | License No State |
|---|---|---|
| 363A00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician AssistantAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Physician Assistant All Other Specialties & Provider Types Physician Assistant Physician Assistants & Advanced Practice Nursing Providers |
| 57237 | OTHER | CA | STATE LICENSE |