Individual provider Active NPI

Jennifer Lynn Dolan, MS, CCC-SLP

  • Speech-Language Pathologist
  • Rancho Mirage, CA
National Provider Identifier
1558505446
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
41946 Issued in CA
Practice address
71780 San Jacinto Dr Ste F2
Rancho Mirage, CA 92270-5518
Phone
(442) 933-9152
Fax
(207) 662-3185
NPI assigned
Apr 23, 2009
Last updated
Sep 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP4369 ME
Speech-Language Pathologist 235Z00000X 41946 CA Primary
Speech-Language Pathologist 235Z00000X SA9881 FL

Addresses

Primary practice location

71780 San Jacinto Dr Ste F2
Rancho Mirage, CA 92270-5518

Mailing address

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 662-4892

Other practice location 1

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 662-4892

Other practice location 2

9040 Jackson Avenue Jblm Cares
Tacoma, WA 98431-3009
Phone (253) 968-7915

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240405002782 OR Practitioner - Qualified Speech Language Pathologist 0143668384 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SA9881FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Charles Health System, Inc. CurrentSince Feb 28, 2024 Accepting new patients
St. Charles Health System, Inc. CurrentSince Feb 28, 2024 Accepting new patients
St. Charles Health System, Inc. Past Accepting new patients

Locations

29358 Network Pl
Chicago, IL 60673

2036 NE Williamson Ct
Bend, OR 97701
Phone (541) 318-4249

211 NW Larch Ave
Redmond, OR 97756
Phone (541) 548-2164

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1240444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1558505446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023134",
            "telephone_number": "207-662-4892",
            "fax_number": "207-662-3185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71780 SAN JACINTO DR STE F2",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922705518",
            "telephone_number": "442-933-9152",
            "fax_number": "207-662-3185"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 Bramhall St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041023134",
            "country_code": "US",
            "telephone_number": "207-662-4892",
            "fax_number": "207-662-3185",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9040 Jackson Avenue Jblm Cares",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984313009",
            "country_code": "US",
            "telephone_number": "253-968-7915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOLAN",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-23",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ME",
            "license": "SP4369",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "41946",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA9881",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.