Individual provider Active NPI

Olivia Carmen Olmsted, AMFT

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1568021152
Registry record updated Jun 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
95201 Issued in CA
Practice address
3650 Standish Ave
Santa Rosa, CA 95407-8113
Phone
(707) 234-5092
Fax
(707) 585-6155
NPI assigned
Jun 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2019

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 95201 CA Primary

Addresses

Primary practice location

3650 Standish Ave
Santa Rosa, CA 95407-8113

Mailing address

1150 Stage Gulch Rd
Petaluma, CA 94954-9541
Phone (206) 390-8520

Other identifiers 1

IdentifierTypeStateIssuer
AMFT95201OtherCABOARD OF BEHAVIORAL SCIENCES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559865600000",
    "number": "1568021152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 STAGE GULCH RD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949549541",
            "telephone_number": "206-390-8520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 STANDISH AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954078113",
            "telephone_number": "707-234-5092",
            "fax_number": "707-585-6155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLMSTED",
        "first_name": "OLIVIA",
        "middle_name": "CARMEN",
        "name_prefix": "Ms.",
        "credential": "AMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-07",
        "last_updated": "2019-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "95201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF BEHAVIORAL SCIENCES",
            "identifier": "AMFT95201",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2019; 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.