Individual provider Active NPI

Catherine C. Olivolo, FNP

  • Family Nurse Practitioner
  • Yreka, CA
National Provider Identifier
1710035993
Registry record updated Nov 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
16876 Issued in CA
Practice address
475 Bruce St
Yreka, CA 96097-3450
Phone
(530) 842-3507
Fax
(530) 842-9412
NPI assigned
Jan 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 16876 CA Primary

Addresses

Primary practice location

475 Bruce St
Yreka, CA 96097-3450

Mailing address

475 Bruce St
Yreka, CA 96097-3474
Phone (530) 842-3507

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100303001065 CA Practitioner - Nurse Practitioner 6800931650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Siskiyou Hospital Inc 96 clinicians

Practice addresses (Care Compare)

444 Bruce St
Yreka, CA 96097-3450
Phone (530) 842-4121

Hospital & facility affiliations

  • Fairchild Medical Center Hospital, Yreka, CA, CCN 051316

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
16876CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Siskiyou Hospital, Inc. CurrentSince Nov 4, 2009 Accepting new patients
Fairchild Medical Group Past Accepting new patients

Locations

475 Bruce St
Ste 500
Yreka, CA 96097
Phone (530) 842-3507

475 Bruce St
Yreka, CA 96097
Phone (530) 842-3507

444 Bruce St
Yreka, CA 96097
Phone (530) 841-6256

475 Bruce St
Ste 900
Yreka, CA 96097

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Madrone Hospice, IncYreka, CA, CCN 051657 Hospice Corporate Director Oct 21, 2009

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1168041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258934400000",
    "number": "1710035993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 BRUCE ST",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960973474",
            "telephone_number": "530-842-3507",
            "fax_number": "530-842-9412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 BRUCE ST",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960973450",
            "telephone_number": "530-842-3507",
            "fax_number": "530-842-9412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVOLO",
        "first_name": "CATHERINE",
        "middle_name": "C.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-06",
        "last_updated": "2009-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "16876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yreka, CA

Sources for this page

Verify at the official NPI Registry.