Healthcare Provider Details

I. General information

NPI: 1700793312
Provider Name (Legal Business Name): MEREDITH KINCAIDE CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

495 VALLEY RD
ARROYO GRANDE CA
93420-3900
US

IV. Provider business mailing address

928 PHILLIPS RD
ARROYO GRANDE CA
93420-5194
US

V. Phone/Fax

Practice location:
  • Phone: 805-474-3200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP.16653
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number40966
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: