Desiree Que Olan, DNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

STUDENT Issued in CA

Practice address

19017 Vanowen St
Reseda, CA 91335-5115

Phone

(818) 942-4568

NPI assigned

Oct 19, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Fullmynd Integrative Psychiatry & Wellness, a Nursing Professional Corporation

  • Adult Mental Health Clinic/Center
  • Lancaster, CA
  • NPI 1447105903
  NPD Authorized official

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

{
    "created_epoch": "1508371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1992216865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43700 17TH ST W STE 201",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935344661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19017 VANOWEN ST",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913355115",
            "telephone_number": "818-942-4568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLAN",
        "first_name": "DESIREE",
        "middle_name": "QUE",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-19",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "780870",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "780870",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "STUDENT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Georgeanna Reyes Octaviano, MS, BCBA
• Dilbar Ofarinova, LMFT
• Offerta Home Health Agency Inc
• May Ogbozor
• Andrew B Ojeda
• Olympus Adhc, Inc.
• Sophary Om, PHARMD
• One Heart Behavioral Health
• One Smile Home Health Inc
• Chinyere Ugo Onyioha, LVN/HEALTHCARE ADMIN

• Nurse Practitioner in Reseda, CA
• Providers in Reseda, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.

Verify at the official NPI Registry.