Individual provider Active NPI

Kira Gabrielle Olivares, RN

  • Registered Nurse
  • Palo Alto, CA
National Provider Identifier
1114678018
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95261372 Issued in CA
Practice address
3801 Miranda Ave
Palo Alto, CA 94304-1290
Phone
(630) 303-3463
NPI assigned
Jan 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95261372 CA Primary

Addresses

Primary practice location

3801 Miranda Ave
Palo Alto, CA 94304-1290

Mailing address

312 Gates Dr Apt 562
Milpitas, CA 95035-8278
Phone (630) 303-3463

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Home

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
95261372CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1641945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1114678018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 GATES DR APT 562",
            "city": "MILPITAS",
            "state": "CA",
            "postal_code": "950358278",
            "telephone_number": "630-303-3463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 MIRANDA AVE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041290",
            "telephone_number": "630-303-3463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVARES",
        "first_name": "KIRA",
        "middle_name": "GABRIELLE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-12",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95261372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Home",
            "affiliation": "N",
            "address_1": "312 Gates Dr Apt 562",
            "city": "Milpitas",
            "state": "CA",
            "country_code": "US",
            "postal_code": "950358278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; 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.