Provider Demographics
NPI:1265317879
Name:BISHOP, OLINA (CPPS)
Entity type:Individual
Prefix:
First Name:OLINA
Middle Name:
Last Name:BISHOP
Suffix:
Gender:F
Credentials:CPPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12121 W OLYMPIC BLVD APT 5113
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-1257
Mailing Address - Country:US
Mailing Address - Phone:310-908-0033
Mailing Address - Fax:
Practice Address - Street 1:1500 W OLYMPIC BLVD # 400
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-3805
Practice Address - Country:US
Practice Address - Phone:323-926-2264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMPSS-EFJSMU175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist