NPIMap

Organization Active NPI

Calico Mental Health Associates LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
National Provider Identifier
1992223861
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
CALICO MENTAL HEALTH ASSOCIATES LLC
Practice address
1520 N Alberta St
Portland, OR 97217-3602
Phone
(503) 914-5229
Fax
(503) 200-1241
NPI assigned
Aug 31, 2017
Last updated
Mar 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Mrs. Amber Marie Flores
Title
Operations Manager
Phone
(503) 914-5229

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X OR Primary

Addresses

Primary practice location

1520 N Alberta St
Portland, OR 97217-3602

Mailing address

4207 SE Woodstock Blvd # 230
Portland, OR 97206-6267
Phone (503) 914-5229

Other practice location 1

1133 NW 21st Ave # 104
Portland, OR 97209-1513
Phone (503) 914-5229

National Provider Directory

National Provider Directory

Locations

1133 NW 21st Ave
#104
Portland, OR 97209
Phone (503) 914-5229

4207 SE Woodstock Blvd
Portland, OR 97206
Phone (503) 312-6005

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1992223861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4207 SE WOODSTOCK BLVD # 230",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972066267",
            "telephone_number": "503-914-5229",
            "fax_number": "503-200-1241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 N ALBERTA ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972173602",
            "telephone_number": "503-914-5229",
            "fax_number": "503-200-1241"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1133 NW 21st Ave # 104",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972091513",
            "country_code": "US",
            "telephone_number": "503-914-5229",
            "fax_number": "503-200-1241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CALICO MENTAL HEALTH ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-31",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "FLORES",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "503-914-5229",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.