Individual provider Active NPI

Olena Kyrdan

  • Speech-Language Assistant
  • San Jose, CA
National Provider Identifier
1659171684
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
5204 Issued in CA
Practice address
2109 Otoole Ave Ste M
San Jose, CA 95131-1338
Phone
(408) 573-7720
NPI assigned
Mar 18, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 5204 CA Primary

Addresses

Primary practice location

2109 Otoole Ave Ste M
San Jose, CA 95131-1338

Mailing address

2109 Otoole Ave Ste M
San Jose, CA 95131-1338

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

State licenses

LicenseStateTypeSpecialty
5204CAMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Play Therapy CurrentSince Aug 25, 2025 Accepting new patients

Locations

2109 Otoole Ave
Ste M
San Jose, CA 95131
Phone (408) 573-7720

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": "1742256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1659171684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2109 OTOOLE AVE STE M",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951311338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 OTOOLE AVE STE M",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951311338",
            "telephone_number": "408-573-7720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYRDAN",
        "first_name": "OLENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-18",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "CA",
            "license": "5204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; 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.