Individual provider Active NPI

Gustavo Olvera

  • Marriage & Family Therapist
  • Mariposa, CA
National Provider Identifier
1912306788
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
129713 Issued in CA
Practice address
5354 Montana del Oro Dr
Mariposa, CA 95338-9343
Phone
(209) 592-7000
Fax
(209) 592-7000
NPI assigned
Aug 18, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 129713 CA Primary

Addresses

Primary practice location

5354 Montana del Oro Dr
Mariposa, CA 95338-9343

Mailing address

5354 Montana del Oro Dr
Mariposa, CA 95338-9343
Phone (209) 592-7000

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

LicenseStateTypeSpecialty
129713CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1408320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1912306788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5354 MONTANA DEL ORO DR",
            "city": "MARIPOSA",
            "state": "CA",
            "postal_code": "953389343",
            "telephone_number": "209-592-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5354 MONTANA DEL ORO DR",
            "city": "MARIPOSA",
            "state": "CA",
            "postal_code": "953389343",
            "telephone_number": "209-592-7000",
            "fax_number": "209-592-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLVERA",
        "first_name": "GUSTAVO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-18",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "129713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mariposa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; 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.