Individual provider Active NPI

Jacqueline Oller, MS

  • Speech-Language Pathologist
  • Tempe, AZ
National Provider Identifier
1124636758
Registry record updated Jul 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
TSLP12516 Issued in AZ
Practice address
1975 E Cornell Dr
Tempe, AZ 85283-2361
Phone
(480) 897-6228
NPI assigned
Jul 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2020

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 TSLP12516 AZ Primary

Addresses

Primary practice location

1975 E Cornell Dr
Tempe, AZ 85283-2361

Mailing address

8553 E Via de Encanto
Scottsdale, AZ 85258-3916
Phone (480) 628-3140

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)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
TSLP12516AZMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1595203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595203200000",
    "number": "1124636758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8553 E VIA DE ENCANTO",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852583916",
            "telephone_number": "480-628-3140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 E CORNELL DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852832361",
            "telephone_number": "480-897-6228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLLER",
        "first_name": "JACQUELINE",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-20",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "TSLP12516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; 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.