Angela M Orvis, PSYD

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

3628-57 Issued in WI

Practice address

4555 W Schroeder Dr
Brown Deer, WI 53223-1475

Phone

(800) 767-4411

Fax

(414) 797-0804

NPI assigned

Jan 11, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1547164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547164800000",
    "number": "1083188122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34700 VALLEY RD",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664599",
            "telephone_number": "800-767-4411",
            "fax_number": "262-646-1049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4555 W SCHROEDER DR",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "532231475",
            "telephone_number": "800-767-4411",
            "fax_number": "414-797-0804"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4600 W Schroeder Dr",
            "address_purpose": "LOCATION",
            "city": "Brown Deer",
            "state": "WI",
            "postal_code": "532231469",
            "country_code": "US",
            "telephone_number": "800-767-4411",
            "fax_number": "414-797-0804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ORVIS",
        "first_name": "ANGELA",
        "middle_name": "M",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-11",
        "last_updated": "2019-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "WI",
            "license": "3628-57",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "3628-57",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "3628-57",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Francisca A Olmedo-Estrada, M.D.
• Ann Olsen, LPTA
• Robert Kent Olson, R.PH.
• Gold A Omereonye, RN
• Reynaldo Ortiz-Maldonado
• Stacey Osley
• Our Home Your Home LLC
• Kariann Kay Pajak Bergeron, MA
• Whitney Palumbo
• Elizabeth L Paly, PT DPT

• Clinical Child & Adolescent Psychologist in Brown Deer, WI
• Providers in Brown Deer, WI by specialty
• Clinical Child & Adolescent Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2019; 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.