Provider Demographics
NPI:1902494305
Name:OLSON, JENNIFER CAMILLE (DACM)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:CAMILLE
Last Name:OLSON
Suffix:
Gender:F
Credentials:DACM
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:CAMILLE
Other - Last Name:JOHNSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DACM
Mailing Address - Street 1:815 30TH ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-4406
Mailing Address - Country:US
Mailing Address - Phone:916-827-8273
Mailing Address - Fax:
Practice Address - Street 1:815 30TH ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-4406
Practice Address - Country:US
Practice Address - Phone:916-827-8273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-02
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18714171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist