CANDELARIA OLVERA GOMEZ (NPI# 1083246557) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083246557 |
| Entity Type | Individual |
| Full Name | CANDELARIA OLVERA GOMEZ |
| Practice Address |
5023 Ne Killingsworth St Portland OR 97218-1915 |
| Mailing Address |
Po Box 8459 Portland OR 97207-8459 |
| Practice Telephone | 5032844249 |
| Mailing Telephone | 5032380769 |
| Enumeration Date | 2020-02-12 |
| Last Update Date | 2020-02-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 372600000X | Adult Companion | Nursing Service Related Providers |
| Street Address |
5023 NE KILLINGSWORTH ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97218-1915 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841360161 | Cascadia Behavioral Healthcare Inc | Clinic/Center | 5023 Ne Killingsworth St, Portland, OR 97218-1915 | 2006-11-08 |
| 1134733827 | Virginia Vera Johnson | Case Manager/Care Coordinator | 5023 Ne Killingsworth St, Portland, OR 97218-1915 | 2020-09-01 |
| 1922611664 | Julian Savery Szieff | Case Manager/Care Coordinator | 5023 Ne Killingsworth St, Portland, OR 97218-1915 | 2020-08-24 |
| 1356954069 | Georgia Long | Technician | 5023 Ne Killingsworth St, Portland, OR 97218-1915 | 2020-08-24 |
| 1083222566 | Courtney Arline Florio | Case Manager/Care Coordinator | 5023 Ne Killingsworth St, Portland, OR 97218-1915 | 2020-07-21 |
| 1942818430 | Semiah Dominique Crawford | Technician | 5023 Ne Killingsworth St, Portland, OR 97218-1915 | 2020-07-21 |
| 1962027912 | Thomas W Rounds | Case Manager/Care Coordinator | 5023 Ne Killingsworth St, Portland, OR 97218-1915 | 2020-06-15 |
| 1104440445 | Anthony P Brasher | Case Manager/Care Coordinator | 5023 Ne Killingsworth St, Portland, OR 97218-1915 | 2020-06-02 |
| 1427670405 | Jamie H Matthews | Adult Companion | 5023 Ne Killingsworth St, Portland, OR 97218-1915 | 2020-05-12 |
| 1730700154 | Sabrina L Martin-hewitt | Adult Companion | 5023 Ne Killingsworth St, Portland, OR 97218-1915 | 2020-04-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043852726 | Alex Margarito | Specialist/Technologist | 6801 Necornfoot Rd, Fpo, AA 97218 | 2019-10-14 |
| 1083101943 | Joyce M Larkins | Specialist | 5852 Ne 42nd Ave., Portland, OR 97218 | 2018-04-17 |
| 1740709658 | Alyssa M Cavalier | Licensed Practical Nurse | 6601 Ne 78th Ct., Suite A3, Portland, OR 97218 | 2017-09-12 |
| 1093266405 | Jean Hansen | Counselor | 6601ne 78th Court Suite, Suite A3, Portland, OR 97218 | 2016-10-20 |
| 1174913636 | Kirsten Kelly-chambers | Counselor | 4310 Ne Killinsworth Street, Portland, OR 97218 | 2015-02-04 |
| 1386962074 | Kathleen Kuhlmey Sheridan | Nurse Practitioner | 5215 Ne 52nd Ave, Portland, OR 97218 | 2010-05-06 |
| 1003049909 | Kevin Richardson | Adult Companion | 5029 Ne Killingsworth St, Portland, OR 97218 | 2009-08-26 |
| 1366676462 | Bobbi Gabriele Kennedy | Military Health Care Provider | 6801 Ne Cornfoot Road, Portland, OR 97218 | 2009-05-05 |
| 1396980751 | Jamie Mercile Taylor | Counselor | 4310 N.e Kilingsworth, Portland, OR 97218 | 2008-12-12 |
| 1902041460 | Brandi Danielle Hess | Counselor | 4450 Ne 76th, Portland, OR 97218 | 2008-12-11 |
| Find all providers in zip 97218 | ||||
| Taxonomy Code | 372600000X |
| Grouping | Nursing Service Related Providers |
| Classification | Adult Companion |
| An individual who provides supervision, socialization, and non-medical care to a functionally impaired adult. Companions may assist or supervise the individual with such tasks as meal preparation, laundry and shopping, but do not perform these activities as discrete services. These services are provided in accordance with a therapeutic goal in the plan of care. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184271462 | Taylor Salter | Adult Companion | 7018 N Armour St, Portland, OR 97203-6132 | 2019-08-21 |
| 1235785429 | Lonzall Tatum | Adult Companion | 1212 Sw Clay St Apt 409, Portland, OR 97201-7822 | 2019-08-13 |
| 1205303021 | Imani Anderson | Adult Companion | 434 Ne Roselawn St, Portland, OR 97211-3826 | 2018-10-30 |
| 1568901858 | Christopher Gabriel Lyons | Adult Companion | 1343 Ne 118 Ave. Apt5, Portland, OR 97220 | 2017-02-20 |
| 1104364900 | Rosanna Hunnicutt | Adult Companion | 2601 Se 160th Ave, Portland, OR 97236-2092 | 2017-02-01 |
| 1043755028 | Raolat Ajibade IIi | Adult Companion | 847 N.e 19thave, Portland, OR 97232 | 2016-12-29 |
| 1164972675 | Rachael Anderson | Adult Companion | 423 Ne 160th Ave #11, Portland, OR 97230 | 2016-10-07 |
| 1255789731 | Sherri Schroeder | Adult Companion | 847 Ne 19th Ave., Suite100, Portland, OR 97232 | 2016-05-25 |
| 1750740577 | Sheila Amoo | Adult Companion | 236 N Killingworth St. Apt.b104, Portland, OR 97217 | 2016-02-22 |
| 1609241371 | Denise Broom | Adult Companion | 25 Ne Stafford St, Portland, OR 97211-2241 | 2015-12-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.