Provider Demographics
NPI:1144019845
Name:FOX, OLIVIA (CD-L, CD-PIC, CLC)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:FOX
Suffix:
Gender:F
Credentials:CD-L, CD-PIC, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1275 4TH ST UNIT 267
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-4057
Mailing Address - Country:US
Mailing Address - Phone:707-480-3235
Mailing Address - Fax:
Practice Address - Street 1:1275 4TH ST UNIT 267
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-4057
Practice Address - Country:US
Practice Address - Phone:707-480-3235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula