Provider Demographics
NPI:1952904518
Name:SANTOS, KEYLA MARIA (MS, CF- SLP)
Entity Type:Individual
Prefix:
First Name:KEYLA
Middle Name:MARIA
Last Name:SANTOS
Suffix:
Gender:F
Credentials:MS, CF- SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E OHIO AVE
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-3421
Mailing Address - Country:US
Mailing Address - Phone:760-747-1275
Mailing Address - Fax:
Practice Address - Street 1:800 E OHIO AVE
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3421
Practice Address - Country:US
Practice Address - Phone:760-747-1275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14996235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist