Individual provider Active NPI

Aileen Marie Dolen

  • Speech-Language Pathologist
  • San Diego, CA
National Provider Identifier
1043734163
Registry record updated Jul 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP11152 Issued in CA
Practice address
2751 Roosevelt Rd Ste 203
San Diego, CA 92106-6180
Phone
(619) 501-9755
NPI assigned
Jul 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP11152 CA Primary

Addresses

Primary practice location

2751 Roosevelt Rd Ste 203
San Diego, CA 92106-6180

Mailing address

3760 Convoy St Ste 204
San Diego, CA 92111-3744
Phone (858) 514-0375

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26824CAMDPhysical Medicine & Rehabilitation Physician
SLP11152CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
New Life Physical Therapy Services, PC Speech-Language Pathologist CurrentSince Jul 1, 2022 Accepting new patients

Locations

12515 Springhurst Dr
San Diego, CA 92128
Phone (858) 771-3694

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501459200000",
    "number": "1043734163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3760 CONVOY ST STE 204",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113744",
            "telephone_number": "858-514-0375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2751 ROOSEVELT RD STE 203",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921066180",
            "telephone_number": "619-501-9755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLEN",
        "first_name": "AILEEN",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-31",
        "last_updated": "2017-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SLP11152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.