MEDICARE: GRACE-ANN SKYE KING M.A.-SLP-CCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	16300	CA

General Provider Information

NPI Number	:	1932087830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRACE-ANN SKYE KING M.A.-SLP-CCC

Provider Business Mailing Address
First Line	:	7616 LAGUNA BEACH WAY
Second Line	:
City	:	ANTELOPE
State	:	CA
Zip	:	95843-4343
Country	:	US
Telephone Number	:	916-320-5336
Fax Number	:

Provider Business Practice Location Address
First Line	:	7616 LAGUNA BEACH WAY
Second Line	:
City	:	ANTELOPE
State	:	CA
Zip	:	95843
Country	:	US
Telephone Number	:	916-320-5336
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2025
Last Update Date	:	08/26/2025

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Directions to “ GRACE-ANN SKYE KING M.A.-SLP-CCC” Practice Location

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