Provider Demographics
NPI:1124143458
Name:OLAND, ALYSSA (PHD)
Entity type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:
Last Name:OLAND
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 UINTA WAY STE 120
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-7198
Mailing Address - Country:US
Mailing Address - Phone:303-344-4100
Mailing Address - Fax:303-265-9397
Practice Address - Street 1:495 UINTA WAY STE 120
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7198
Practice Address - Country:US
Practice Address - Phone:303-344-4100
Practice Address - Fax:303-265-9397
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3255103TC2200X
CAPSY 21667103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO79606253Medicaid
CO391919YLSHMedicare PIN