Healthcare Provider Details

I. General information

NPI: 1376249979
Provider Name (Legal Business Name): PATRICK OLLAR PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2023
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

732 S 6TH ST # 4912
LAS VEGAS NV
89101-6948
US

IV. Provider business mailing address

2108 N ST # 10416
SACRAMENTO CA
95816-5712
US

V. Phone/Fax

Practice location:
  • Phone: 702-551-2522
  • Fax: 702-344-2986
Mailing address:
  • Phone: 702-551-2522
  • Fax: 702-344-2986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number95186979
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95032182
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number876560
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: