Edna Mariana Olivares Gomez

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

125285 Issued in CA

Practice address

1333 Willow Pass Rd Ste 102
Concord, CA 94520-5225

Phone

(510) 745-9151

NPI assigned

Jun 23, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1529712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1306331228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5776 STONERIDGE MALL RD STE 340",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945884514",
            "telephone_number": "925-223-8047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 WILLOW PASS RD STE 102",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945205225",
            "telephone_number": "510-745-9151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVARES GOMEZ",
        "first_name": "EDNA",
        "middle_name": "MARIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-23",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "125285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "96758262G57299",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Briana Rose Olazabal
• Susan Elizabeth Olden-Grant
• Laurie Oldham, P.A.-C
• Shreeya Oli
• Maureen Olivar-Kim
• Sulamita Oliveira
• Julianna Oliver
• Re'Niyah Oliver
• Amanda Michelle Olivier, BCBA
• Denise Olivieri

• Marriage & Family Therapist in Concord, CA
• Providers in Concord, 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 10, 2021; 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.