Marylyn Celeste Olmedo

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

AMFT144746 Issued in CA

Practice address

4590 Allstate Dr
Riverside, CA 92501-1702

Phone

(909) 599-1227

NPI assigned

May 17, 2019

Reactivated

May 14, 2024

Last updated

Jun 28, 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 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• McKinley Children's Center

  • Community/Behavioral Health Agency
  • Riverside, CA
  • NPI 1831691880
  NPD
• McKinley Children's Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Riverside, CA
  • NPI 1528743846
  NPD

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

{
    "created_epoch": "1558051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1245896976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4590 ALLSTATE DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925011702",
            "telephone_number": "909-599-1227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4590 ALLSTATE DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925011702",
            "telephone_number": "909-599-1227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLMEDO",
        "first_name": "MARYLYN",
        "middle_name": "CELESTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-17",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "deactivation_date": "2024-02-05",
        "reactivation_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT144746",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Graciela Oliver
• Robert Oliver, PA
• Theodore Ronald Oliver, DPT
• Vannea Chantel Olivo-Prado
• Lizette Olmedo
• Angel Olmos
• Brenda Olmos, RN
• Daisy Olmos
• Maria Sanjuana Olmos
• Meghan Olmos

• Marriage & Family Therapist in Riverside, CA
• Providers in Riverside, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; 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.