Individual provider Active NPI

Olivia Joyce Tudor, PH.D.

  • Clinical Psychologist
  • Albuquerque, NM
National Provider Identifier
1043448574
Registry record updated Jun 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
349 Issued in NM
Practice address
9524 Bent Rd NE
Albuquerque, NM 87109-6394
Phone
(505) 292-3816
NPI assigned
Jun 23, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 349 NM Primary

Addresses

Primary practice location

9524 Bent Rd NE
Albuquerque, NM 87109-6394

Mailing address

9524 Bent Rd NE
Albuquerque, NM 87109-6394
Phone (505) 292-3816

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
349NMMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245715200000",
    "number": "1043448574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9524 BENT RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871096394",
            "telephone_number": "505-292-3816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9524 BENT RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871096394",
            "telephone_number": "505-292-3816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUDOR",
        "first_name": "OLIVIA",
        "middle_name": "JOYCE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-23",
        "last_updated": "2009-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NM",
            "license": "349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2009; 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.