Healthcare Provider Details

I. General information

NPI: 1821590712
Provider Name (Legal Business Name): KELSEY GUNBY CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2018
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3738 WALNUT AVE
CARMICHAEL CA
95608-3054
US

IV. Provider business mailing address

6809 KITTERY AVE
CITRUS HEIGHTS CA
95621-4117
US

V. Phone/Fax

Practice location:
  • Phone: 916-971-7700
  • Fax:
Mailing address:
  • Phone: 916-591-6472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number36248
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: