Healthcare Provider Details

I. General information

NPI: 1043128689
Provider Name (Legal Business Name): KELSIE LENSING MHS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1935 MARLINDA WAY
EL CAJON CA
92021-1155
US

IV. Provider business mailing address

11839 TIERRA DEL SUR APT A
SAN DIEGO CA
92130-2905
US

V. Phone/Fax

Practice location:
  • Phone: 619-956-5100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number42024
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: