Laurie Oldham, P.A.-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA 19052 Issued in CA

Practice address

2350 Pacheco St
Concord, CA 94520-2018

Phone

(925) 676-2600

Fax

(925) 680-0212

NPI assigned

Mar 8, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1841321841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 WEBSTER ST",
            "address_2": "SUITE 500",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093117",
            "telephone_number": "510-465-6600",
            "fax_number": "510-839-0806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 PACHECO ST",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945202018",
            "telephone_number": "925-676-2600",
            "fax_number": "925-680-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDHAM",
        "first_name": "LAURIE",
        "name_prefix": "Ms.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA 19052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Rae Olague, PA
• John Olander
• Carolina Olayo
• Briana Rose Olazabal
• Susan Elizabeth Olden-Grant
• Lydia J Olguin
• Shreeya Oli
• Maureen Olivar-Kim
• Edna Mariana Olivares Gomez
• Sulamita Oliveira

• Surgical Physician Assistant in Concord, CA
• Providers in Concord, CA by specialty
• Surgical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; 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.