Individual provider Active NPI

Taylor Olson, FNP-C

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1124906664
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95038236 Issued in CA
Practice address
4020 Willamette Ave
San Diego, CA 92117-3857
Phone
(774) 573-0245
NPI assigned
Aug 22, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95038236 CA Primary
Registered Nurse 163W00000X 95249647 CA

Addresses

Primary practice location

4020 Willamette Ave
San Diego, CA 92117-3857

Mailing address

165 Laurelwood Dr
Hopedale, MA 01747-1954
Phone (774) 573-0245

Other practice location 1

165 Laurelwood Dr
Hopedale, MA 01747-1954
Phone (774) 573-0245

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260513002192 CA Practitioner - Nurse Practitioner 8921577560 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

320 Santa Fe Dr
Suite 204
Encinitas, CA 92024-5100

PO Box
Suite 1716
Pleasanton, CA 94566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95249647CAMDRegistered Nurse
95038236CAMDFamily Nurse Practitioner

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": "1755820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1124906664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 LAURELWOOD DR",
            "city": "HOPEDALE",
            "state": "MA",
            "postal_code": "017471954",
            "telephone_number": "774-573-0245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 WILLAMETTE AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921173857",
            "telephone_number": "774-573-0245"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "165 Laurelwood Dr",
            "address_purpose": "LOCATION",
            "city": "Hopedale",
            "state": "MA",
            "postal_code": "017471954",
            "country_code": "US",
            "telephone_number": "774-573-0245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSON",
        "first_name": "TAYLOR",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-22",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95038236",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95249647",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.