Andrea Marissa Olivas, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA64496 Issued in CA

Practice address

3280 Professional Dr
Auburn, CA 95602-2412

Phone

(530) 886-8630

Fax

(530) 886-8629

NPI assigned

May 18, 2024

Last updated

Nov 14, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: aolivas653671@hisp.ehr.sutterhealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Auburn Medical Group, Inc

  • General Practice Physician
  • Auburn, CA
  • NPI 1720192560
  NPD (past)
• Edmund Yao MD Inc

  • Internal Medicine Physician
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  • NPI 1285969139
  NPD (past)

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

{
    "created_epoch": "1715990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1083463277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3280 PROFESSIONAL DR",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956022412",
            "telephone_number": "530-886-8630",
            "fax_number": "530-886-8629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3280 PROFESSIONAL DR",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956022412",
            "telephone_number": "530-886-8630",
            "fax_number": "530-886-8629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVAS",
        "first_name": "ANDREA",
        "middle_name": "MARISSA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-18",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA64496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Of Heaven and Earth Healing LLC
• Patrick David Ogilvie, MD
• Okhovat Dental Practice of Auburn
• Benjamin Richard Oldach, DO
• Erik Olesen, MFC
• David Allen Oliver, MD
• Jillian Lee Oliver, FNP
• Alexandria Nicole Olosunde, LMFT
• Caitlin Olsen, MS
• Rhonda M Olson

• Physician Assistant in Auburn, CA
• Providers in Auburn, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.