Healthcare Provider Details

I. General information

NPI: 1831045806
Provider Name (Legal Business Name): KACEE LORRAINE FORRESTER SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2026
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1699 W MAIN ST STE N
EL CENTRO CA
92243-5403
US

IV. Provider business mailing address

621 GARRETT ST
BRAWLEY CA
92227-3205
US

V. Phone/Fax

Practice location:
  • Phone: 760-483-3065
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number30742
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: