Larissa Michele Oberholtzer-Gallagher, RN

Primary specialty

Critical Care Medicine Registered NurseTaxonomy code 163WC0200X

License

562922 Issued in CA

Practice address

2 Regency Dr
Clayton, CA 94517-1715

Phone

(925) 693-0545

Fax

(925) 693-0545

NPI assigned

Jan 13, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1610496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1023607017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 REGENCY DR",
            "city": "CLAYTON",
            "state": "CA",
            "postal_code": "945171715",
            "telephone_number": "925-693-0545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 REGENCY DR",
            "city": "CLAYTON",
            "state": "CA",
            "postal_code": "945171715",
            "telephone_number": "925-693-0545",
            "fax_number": "925-693-0545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBERHOLTZER-GALLAGHER",
        "first_name": "LARISSA",
        "middle_name": "MICHELE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-13",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "CA",
            "license": "562922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NOT APPLICABLE",
            "identifier": "888",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "beanymoose@hotmail.com",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "information",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "information",
            "address_1": "2 Regency Dr",
            "city": "Clayton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945171715",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "beanymoose@hotmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "2 Regency Dr",
            "city": "Clayton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945171715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Critical Care Medicine Registered Nurse in Clayton, CA
• Providers in Clayton, CA by specialty
• Critical Care Medicine Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.