Individual provider Active NPI

Teresa Dolores Olvera, LMFT

  • Marriage & Family Therapist
  • Modesto, CA
National Provider Identifier
1396864583
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
118689 Issued in CA
Practice address
1416 Vlach Way
Modesto, CA 95351-4241
Phone
(209) 499-2422
NPI assigned
Mar 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 118689 CA Primary

Addresses

Primary practice location

1416 Vlach Way
Modesto, CA 95351-4241

Mailing address

1416 Vlach Way
Modesto, CA 95351-4241
Phone (209) 499-2422

Other practice location 1

2528 Leslie Ln
Ceres, CA 95307-2326
Phone (209) 538-7331

Other practice location 2

3212 Uranus Dr
Ceres, CA 95307-3010
Phone (209) 531-2088

Other practice location 3

1708 Banyan Ct
Ceres, CA 95307-1907
Phone (209) 538-1888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250822003758 CA Practitioner - Marriage and Family Therapist 1658871751 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2006
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1212 N California St
Stockton, CA 95202-1552

21151 S Western Ave
Suite B22
Torrance, CA 90501-1724

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Joaquin CurrentSince Jun 9, 2025 Accepting new patients
San Joaquin Behavioral Health Services Marriage & Family Therapist Current Accepting new patients
San Joaquin County Behavioral Health Services CurrentSince Jun 9, 2025 Accepting new patients
Elite Family Systems Past Accepting new patients
Elite Family Systems PastSince Apr 11, 2021 Accepting new patients
Elite Family Systems PastSince Apr 11, 2021 Accepting new patients
Elite Family Systems PastSince Apr 11, 2021 Accepting new patients

Locations

1209 W Tokay St
Ste 5
Lodi, CA 95240
Phone (209) 331-2070

1212 N California St
Stockton, CA 95202
Phone (209) 468-8660

Organizations & group practices 7

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": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1396864583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 VLACH WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953514241",
            "telephone_number": "209-499-2422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1416 VLACH WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953514241",
            "telephone_number": "209-499-2422"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2528 Leslie Ln",
            "address_purpose": "LOCATION",
            "city": "Ceres",
            "state": "CA",
            "postal_code": "953072326",
            "country_code": "US",
            "telephone_number": "209-538-7331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3212 Uranus Dr",
            "address_purpose": "LOCATION",
            "city": "Ceres",
            "state": "CA",
            "postal_code": "953073010",
            "country_code": "US",
            "telephone_number": "209-531-2088",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1708 Banyan Ct",
            "address_purpose": "LOCATION",
            "city": "Ceres",
            "state": "CA",
            "postal_code": "953071907",
            "country_code": "US",
            "telephone_number": "209-538-1888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLVERA",
        "first_name": "TERESA",
        "middle_name": "DOLORES",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "118689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.