Provider Demographics
NPI:1831247154
Name:NOLAN, STEVEN CARLTON (MA, CCC-A)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:CARLTON
Last Name:NOLAN
Suffix:
Gender:M
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6877 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:GRANITE BAY
Mailing Address - State:CA
Mailing Address - Zip Code:95746-8169
Mailing Address - Country:US
Mailing Address - Phone:916-791-2671
Mailing Address - Fax:916-771-6681
Practice Address - Street 1:2120 PROFESSIONAL DR
Practice Address - Street 2:SUITE 220
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3700
Practice Address - Country:US
Practice Address - Phone:916-771-6680
Practice Address - Fax:916-771-6681
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU-328231H00000X
CAHA-3940237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHA-3940OtherHEARING AID FITTER
CAAU-328OtherAUDIOLOGY LICENSE