Individual provider Active NPI

Oscar Saldivar Ureno, B.A.

  • Clinical Psychologist
  • Oakland, CA
National Provider Identifier
1376722793
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY61180890 Issued in WA
Practice address
9925 International Blvd
Suite 6
Oakland, CA 94603-2558
Phone
(510) 562-3734
NPI assigned
Nov 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Psychologist 103TC0700X PY61180890 WA Primary

Addresses

Primary practice location

9925 International Blvd
Suite 6
Oakland, CA 94603-2558

Mailing address

9925 International Blvd
Suite 6
Oakland, CA 94603-2558
Phone (510) 562-3734

Other practice location 1

3400 Main St
Vancouver, WA 98663-2223
Phone (360) 696-5044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220127002317 WA Practitioner - Clinical Psychologist 0446642276 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PeacehealthGroup PAC ID 8820178288, 245 clinicians

Practice addresses (Care Compare)

505 NE 87TH Ave
Vancouver, WA 98664-1965

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
PY61180890WAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth CurrentSince Jan 3, 2022 Accepting new patients
Peacehealth CurrentSince Sep 24, 2023 Accepting new patients

Locations

400 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2000

1115 SE 164th Ave
Dept 364
Vancouver, WA 98683
Phone (360) 735-8100

505 NE 87th Ave
Ste 301
Vancouver, WA 98664
Phone (360) 514-1854

3400 Main St
Vancouver, WA 98663
Phone (360) 696-5016

8716 E Mill Plain Blvd
Vancouver, WA 98664
Phone (360) 514-4325

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1193875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1376722793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9925 INTERNATIONAL BLVD",
            "address_2": "SUITE 6",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946032558",
            "telephone_number": "510-562-3734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9925 INTERNATIONAL BLVD",
            "address_2": "SUITE 6",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946032558",
            "telephone_number": "510-562-3734"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 Main St",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986632223",
            "country_code": "US",
            "telephone_number": "360-696-5044",
            "fax_number": "360-696-5451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "URENO",
        "first_name": "OSCAR",
        "middle_name": "SALDIVAR",
        "name_prefix": "Mr.",
        "credential": "B.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-01",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY61180890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.