Active NPI
Matthew Ryan Olson, MA, CCC-SLP
- Speech-Language Pathologist
- Fresno, CA
National Provider Identifier
1720550593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 27501
- Practice address
- 1301 M St
Fresno, CA 93721-1807 - Phone
- (559) 457-3220
- NPI assigned
- Dec 18, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 27501 | CA | Primary |
Addresses
Primary practice location
1301 M St
Fresno, CA 93721-1807
Mailing address
210 N Bush Ave
Clovis, CA 93612-0261
Phone (559) 458-8578
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27501 | CA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545091200000",
"number": "1720550593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 N BUSH AVE",
"city": "CLOVIS",
"state": "CA",
"postal_code": "936120261",
"telephone_number": "559-458-8578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 M ST",
"city": "FRESNO",
"state": "CA",
"postal_code": "937211807",
"telephone_number": "559-457-3220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "MATTHEW",
"middle_name": "RYAN",
"credential": "MA, CCC-SLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-12-18",
"last_updated": "2018-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "27501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.