Individual provider Active NPI

Glenda J Olivier, PHD

  • Psychologist
  • San Diego, CA
National Provider Identifier
1700176351
Registry record updated Nov 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY 17106 Issued in CA
Practice address
10650 Scripps Ranch Blvd
Ste 131
San Diego, CA 92131-2470
Phone
(858) 243-1300
NPI assigned
Apr 17, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY 17106 CA Primary

Addresses

Primary practice location

10650 Scripps Ranch Blvd
Ste 131
San Diego, CA 92131-2470

Mailing address

PO Box 863
Carlsbad, CA 92018-0863
Phone (858) 243-1300

Other names 1

  • Dr. Glenda J Olivier Former name

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY 17106CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1302998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479772800000",
    "number": "1700176351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 863",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920180863",
            "telephone_number": "858-243-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10650 SCRIPPS RANCH BLVD",
            "address_2": "STE 131",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921312470",
            "telephone_number": "858-243-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVIER",
        "first_name": "GLENDA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-17",
        "last_updated": "2016-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY 17106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLENDA",
            "last_name": "OLIVIER",
            "middle_name": "J",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2016; 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.