Provider Demographics
NPI:1396513438
Name:GIRARD, KELSEY ANN (CCC-SLP)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:ANN
Last Name:GIRARD
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 RODONOVAN CT
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-6659
Mailing Address - Country:US
Mailing Address - Phone:650-796-4493
Mailing Address - Fax:
Practice Address - Street 1:1291 S BERNARDO AVE
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-2060
Practice Address - Country:US
Practice Address - Phone:408-245-8070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP35522235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist