Active NPI
Carol Ann Dell'Oliver, PH.D.
- Clinical Psychologist
- Portland, OR
National Provider Identifier
1194981589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3468
- Practice address
- 4838 NE Sandy Blvd Ste 200
Portland, OR 97213-2090 - Phone
- (503) 279-8160
- Fax
- (503) 239-0028
- NPI assigned
- Aug 5, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3468 | OR | Primary |
Addresses
Primary practice location
4838 NE Sandy Blvd Ste 200
Portland, OR 97213-2090
Mailing address
4838 NE Sandy Blvd Ste 200
Portland, OR 97213-2090
Phone (503) 279-8160
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3468 | OR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667952000000",
"number": "1194981589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4838 NE SANDY BLVD STE 200",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972132090",
"telephone_number": "503-279-8160",
"fax_number": "503-239-0028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4838 NE SANDY BLVD STE 200",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972132090",
"telephone_number": "503-279-8160",
"fax_number": "503-239-0028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELL'OLIVER",
"first_name": "CAROL",
"middle_name": "ANN",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-08-05",
"last_updated": "2022-11-09",
"certification_date": "2022-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "3468",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.