Justine Dolan, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

1952 Ascot Dr
Moraga, CA 94556-1449

Phone

(925) 388-9144

NPI assigned

Apr 2, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Neuro Speech & Voice LLC

  • Speech-Language Pathologist
  • Moraga, CA
  • NPI 1194477018

  Single Specialty

  NPD Authorized official
• Neuro Speech & Voice

  • Speech-Language Pathologist
  • Moraga, CA
  • NPI 1033041330

  Single Specialty

  NPD (past) Authorized official

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1386765121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1952 ASCOT DR",
            "city": "MORAGA",
            "state": "CA",
            "postal_code": "945561449",
            "telephone_number": "925-388-9144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1952 ASCOT DR",
            "city": "MORAGA",
            "state": "CA",
            "postal_code": "945561449",
            "telephone_number": "925-388-9144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLAN",
        "first_name": "JUSTINE",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2022-02-11",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CT",
            "license": "003721",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4501 Broadway",
            "city": "Oakland",
            "state": "CA",
            "country_code": "US",
            "postal_code": "94611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alexandra Coleman, M.S.,CCC-SLP
• Mary Ann Crahan, FNP
• Cynthia Ann Cutshall, PH.D.
• Elena Davydova, LLMSW
• Divine Health Inc
• Niva Dotan
• Sally Elton, ATC
• Eric L. Axelrode, D.D.S., a Professional Corporation
• Karen A Ferguson, PHD
• Rhiannon Geving, MATRN, ATC

• Speech-Language Pathologist in Moraga, CA
• Providers in Moraga, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; 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.