Victoria Alysse De la Llama, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L8586 Issued in OR

Practice address

3990 Collins Way Ste 202
Lake Oswego, OR 97035-3459

Phone

(503) 675-2830

NPI assigned

May 17, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1407420110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2014 SE 12TH AVE APT 307",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972145380",
            "telephone_number": "318-754-5009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 COLLINS WAY STE 202",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970353459",
            "telephone_number": "503-675-2830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA LLAMA",
        "first_name": "VICTORIA",
        "middle_name": "ALYSSE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-17",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L8586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark C Davis, PA
• Steve J Davis, RYT, LMT, NCTMB
• Tierra Davis
• Jonah Day
• Chantelle De Jager
• Nancy Lynn De Turk, LMT
• Laila Deardorff, P.T.
• Isabel Deaver, LPC
• Kim Deaver, ATC
• Eleanor B Debakker, PT

• Clinical Social Worker in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.