Individual provider Active NPI

Laroysha Shawntae Ulmer, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Walnut Creek, CA
National Provider Identifier
1598430647
Registry record updated Apr 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95018477 Issued in CA
Practice address
201 N Civic Dr Ste 183
Walnut Creek, CA 94596-3864
Phone
(855) 501-1004
NPI assigned
Aug 11, 2021
Last updated
Apr 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95018477 CA Primary

Addresses

Primary practice location

201 N Civic Dr Ste 183
Walnut Creek, CA 94596-3864

Mailing address

3835 N Freeway Blvd Ste 100
Sacramento, CA 95834-1954

Other practice location 1

102 Buford Ave Ste A
Anderson, SC 29621-3365
Phone (864) 261-9506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230425001531 SC Practitioner - Nurse Practitioner 5799140810 Reassigns benefits to 2 organizations
I20260501000255 CA Practitioner - Nurse Practitioner 5799140810 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3835 N Fwy Blvd
Suite 100
Sacramento, CA 95834-1954

3835 N Fwy Blvd 100
Sacramento, CA 95834-1954

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95018477CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Dept of Mental Health Accounting Office CurrentSince May 17, 2024 Accepting new patients
South Carolina Dept of Mental Health Accounting Office Current Accepting new patients
Bon Secours Medical Group Greenville Specialty Care LLC CurrentSince Mar 12, 2023 Accepting new patients
Bon Secours Medical Group Greenville Specialty Care LLC CurrentSince Mar 12, 2023 Accepting new patients
South Carolina Dept of Mental Health Accounting Office CurrentSince May 17, 2024 Accepting new patients
Rogers Behavioral Health, Inc. Past Accepting new patients
Rogers Behavioral Health, Inc. Past Accepting new patients

Locations

1800 Colonial Dr
Columbia, SC 29203
Phone (803) 898-0123

2715 Colonial Dr
Columbia, SC 29203
Phone (803) 898-4777

317 Saint Francis Dr
Ste 220
Greenville, SC 29601
Phone (864) 255-1901

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1628640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776384000000",
    "number": "1598430647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3835 N FREEWAY BLVD STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N CIVIC DR STE 183",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945963864",
            "telephone_number": "855-501-1004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 Buford Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Anderson",
            "state": "SC",
            "postal_code": "296213365",
            "country_code": "US",
            "telephone_number": "864-261-9506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ULMER",
        "first_name": "LAROYSHA",
        "middle_name": "SHAWNTAE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-11",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95018477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.