Active NPI
Melinda B Olivas, PSY.D
- Clinical Psychologist
- Santa Fe Springs, CA
National Provider Identifier
1871636860
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- RPS 2012150
- Practice address
- 11741 Telegraph Rd Ste G
Santa Fe Springs, CA 90670-3687 - Phone
- (562) 942-8256
- NPI assigned
- Feb 15, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Counselor | 225C00000X | |||
| Clinical Psychologist | 103TC0700X | RPS 2012150 | CA | Primary |
Addresses
Primary practice location
11741 Telegraph Rd Ste G
Santa Fe Springs, CA 90670-3687
Mailing address
PO Box 203
San Dimas, CA 91773-0203
Phone (800) 275-8777
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 225400000X | Other | CA | MENTAL HEALTH WORKER |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPS 2012150 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725408000000",
"number": "1871636860",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 203",
"city": "SAN DIMAS",
"state": "CA",
"postal_code": "917730203",
"telephone_number": "800-275-8777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11741 TELEGRAPH RD STE G",
"city": "SANTA FE SPRINGS",
"state": "CA",
"postal_code": "906703687",
"telephone_number": "562-942-8256"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLIVAS",
"first_name": "MELINDA",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "PSY.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-15",
"last_updated": "2024-09-04",
"certification_date": "2024-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "225C00000X",
"taxonomy_group": "",
"desc": "Rehabilitation Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "RPS 2012150",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MENTAL HEALTH WORKER",
"identifier": "225400000X",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe Springs, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.