Olivia Tess Jeske, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP25948 Issued in CA

Practice address

1133 N H St Ste I
Lompoc, CA 93436-8137

Phone

(805) 733-4542

Fax

(805) 733-4392

NPI assigned

Nov 30, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Olivia Tess Donda Former name

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.

• Cross Speech and Language Center

  • Speech-Language Pathologist
  • Lompoc, CA
  • NPI 1730377433
  NPD (past)

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

{
    "created_epoch": "1512000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512000000000",
    "number": "1710491659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 N H ST STE I",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934368137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 N H ST STE I",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934368137",
            "telephone_number": "805-733-4542",
            "fax_number": "805-733-4392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESKE",
        "first_name": "OLIVIA",
        "middle_name": "TESS",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-30",
        "last_updated": "2017-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP25948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSP00390",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLIVIA",
            "last_name": "DONDA",
            "middle_name": "TESS",
            "credential": "MAIDEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jose Jaramillo Jr.
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• Kai Chin Jeng, MD
• Travis Dean Jenkins
• Colleen O'Connor Jensen, RN, PHN
• Debra Jewell
• Karina Stephanie Jimenez Patino
• Michelle Jimenez, RN, BSN
• Johnny Flores Dental Corp
• Mary Ann Johnson

• Speech-Language Pathologist in Lompoc, CA
• Providers in Lompoc, 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 Nov 30, 2017; 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.