=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386593465
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NVELUP TELEHEALTH PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/22/2026
-----------------------------------------------------
Last Update Date | 01/22/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1020 SW TAYLOR ST STE 540
-----------------------------------------------------
City | PORTLAND
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97205-2527
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-242-9202
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 7221
-----------------------------------------------------
City | PETALUMA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94955-7221
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-324-9906
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | COO
-----------------------------------------------------
Name | TROY DI LELLO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 415-324-9906
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------