Healthcare Provider Details

I. General information

NPI: 1083526701
Provider Name (Legal Business Name): SHAELYN ROSE MCCREADY SLPA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 JAMACHA RD
EL CAJON CA
92019-2359
US

IV. Provider business mailing address

2920 CLAIREMONT DR APT 38
SAN DIEGO CA
92117-6768
US

V. Phone/Fax

Practice location:
  • Phone: 619-588-3545
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number7365
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: