Provider Demographics
NPI:1104032820
Name:NOLAN, APRIL MACHELLE (MED, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:APRIL
Middle Name:MACHELLE
Last Name:NOLAN
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6965 SAN LUIS AVE
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-4058
Mailing Address - Country:US
Mailing Address - Phone:805-591-7188
Mailing Address - Fax:805-591-7189
Practice Address - Street 1:6965 SAN LUIS AVE
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-4058
Practice Address - Country:US
Practice Address - Phone:805-591-7188
Practice Address - Fax:805-591-7189
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP15939235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0663623OtherTRIWEST
CAGSP000390Medicaid
CACB232274Medicare PIN