Odilia Olivares, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

149 Issued in CA

Practice address

12540 Pierce St
Pacoima, CA 91331-1701

Phone

(818) 897-2193

Fax

(818) 899-3864

NPI assigned

Aug 3, 2005

Sex

Female

Sole proprietor

No

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: odilia.olivares.p1@direct.nevhc.nextgenshare.com

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.

• Northeast Valley Health Corporation

  • Federally Qualified Health Center (FQHC)
  • Van Nuys, CA
  • NPI 1629079009
  Medicare reassignment
• Northeast Valley Health Corporation

  • Federally Qualified Health Center (FQHC)
  • Santa Clarita, CA
  • NPI 1548960834
  NPD
• Northeast Valley Health Corporation

  • Dental Clinic/Center
  • Santa Clarita, CA
  • NPI 1689925729
  NPD
• Northeast Valley Health Corporation

  • Federally Qualified Health Center (FQHC)
  • Pacoima, CA
  • NPI 1053312587
  NPD (past)

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1457352247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1172 N MACLAY AVE",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913401328",
            "telephone_number": "818-898-1388",
            "fax_number": "818-365-4031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12540 PIERCE ST",
            "city": "PACOIMA",
            "state": "CA",
            "postal_code": "913311701",
            "telephone_number": "818-897-2193",
            "fax_number": "818-899-3864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVARES",
        "first_name": "ODILIA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-03",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Perez Nunez, NURSE PRACTITIONER
• Monica Nunez, MSW
• Merissa Ocegueda
• Haruka Odombrown
• Chris Ojoh
• Alejandro Olmos
• Laura Ehab Omar, LCSW
• Francis G Onikeku, CRT
• Priscilla Orozco
• Jordan Ortega

• Physician Assistant in Pacoima, CA
• Providers in Pacoima, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.