Active NPI
Luis Olivera Jr.
- Counselor
- Greenbrae, CA
National Provider Identifier
1295277697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 250 Bon Air Rd Unit B
Greenbrae, CA 94904-1702 - Phone
- (415) 473-6835
- NPI assigned
- Nov 16, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | E2506003 | CA | |
| Counselor | 101Y00000X | CA | Primary |
Addresses
Primary practice location
250 Bon Air Rd Unit B
Greenbrae, CA 94904-1702
Mailing address
250 Bon Air Rd Unit B
Greenbrae, CA 94904-1702
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E2506003 | CA | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Marin | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Greenbrae, CA
- NPI 1962839803
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480550400000",
"number": "1295277697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 BON AIR RD UNIT B",
"city": "GREENBRAE",
"state": "CA",
"postal_code": "949041702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 BON AIR RD UNIT B",
"city": "GREENBRAE",
"state": "CA",
"postal_code": "949041702",
"telephone_number": "415-473-6835"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLIVERA",
"first_name": "LUIS",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-11-16",
"last_updated": "2016-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": "E2506003",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenbrae, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.