Active NPI
Laura Miranda Olivera, PSYD, BCBA
- Clinical Psychologist
- Broomfield, CO
National Provider Identifier
1003414855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY0007007
- Practice address
- 320 E 1St Ave Ste 101
Broomfield, CO 80020-3786 - Phone
- (720) 259-5500
- NPI assigned
- Oct 14, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | 36536 | CA | |
| Clinical Psychologist | 103TC0700X | PSY0007007 | CO | Primary |
| Behavior Analyst | 103K00000X | 004593-01 | NY |
Addresses
Primary practice location
320 E 1St Ave Ste 101
Broomfield, CO 80020-3786
Mailing address
320 E 1St Ave Ste 101
Broomfield, CO 80020-3786
Phone (720) 259-5500
Other practice location 1
2131 Ashton Ave
Menlo Park, CA 94025-6501
Phone (650) 260-8701
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004593-01 | NY | MD | Behavioral Analyst |
| PSY0007007 | CO | MD | Clinical Psychologist |
| 36536 | CA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jigsaw Diagnostics New Jersey PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Cognitive & Behavioral Psychologist
- Fort Lee, NJ
- NPI 1508724147
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778544000000",
"number": "1003414855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 E 1ST AVE STE 101",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800203786",
"telephone_number": "720-259-5500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 E 1ST AVE STE 101",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800203786",
"telephone_number": "720-259-5500"
}
],
"practiceLocations": [
{
"address_1": "2131 Ashton Ave",
"address_purpose": "LOCATION",
"city": "Menlo Park",
"state": "CA",
"postal_code": "940256501",
"country_code": "US",
"telephone_number": "650-260-8701",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MIRANDA OLIVERA",
"first_name": "LAURA",
"credential": "PSYD, BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-14",
"last_updated": "2026-05-12",
"certification_date": "2026-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": "CA",
"license": "36536",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CO",
"license": "PSY0007007",
"primary": true
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NY",
"license": "004593-01",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Broomfield, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.