Provider Demographics
NPI:1679374540
Name:JESSICA BYRD-OLMSTEAD, PH.D., INC.
Entity type:Organization
Organization Name:JESSICA BYRD-OLMSTEAD, PH.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BYRD-OLMSTEAD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:408-409-5107
Mailing Address - Street 1:582 LIGHTHOUSE AVE STE 21
Mailing Address - Street 2:
Mailing Address - City:PACIFIC GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:93950-2675
Mailing Address - Country:US
Mailing Address - Phone:408-409-5107
Mailing Address - Fax:
Practice Address - Street 1:582 LIGHTHOUSE AVE STE 21
Practice Address - Street 2:
Practice Address - City:PACIFIC GROVE
Practice Address - State:CA
Practice Address - Zip Code:93950-2675
Practice Address - Country:US
Practice Address - Phone:408-409-5107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Single Specialty