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NPI Code Detail

MEDICARE: NVELUP TELEHEALTH PLLC

MEDICARE: NVELUP TELEHEALTH PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician

General Provider Information

NPI Number : 1386593465
Entity Type Code : Organization
Provider Name (Legal Business Name) : NVELUP TELEHEALTH PLLC
Provider Business Mailing Address
First Line : PO BOX 7221
Second Line :
City : PETALUMA
State : CA
Zip : 94955-7221
Country : US
Telephone Number : 415-324-9906
Fax Number :
Provider Business Practice Location Address
First Line : 1020 SW TAYLOR ST STE 540
Second Line :
City : PORTLAND
State : OR
Zip : 97205-2527
Country : US
Telephone Number : 509-242-9202
Fax Number :
Authorized Official
Title or Position : COO
Name : TROY DI LELLO
Credential :
Telephone Number : 415-324-9906
Provider Enumeration Date : 01/22/2026
Last Update Date : 01/22/2026

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Directions to “NVELUP TELEHEALTH PLLC ” Practice Location

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