Healthcare Provider Details

I. General information

NPI: 1326972167
Provider Name (Legal Business Name): SARAH KENNEDY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1809 S JUNIPER ST
ESCONDIDO CA
92025-6240
US

IV. Provider business mailing address

951 N VULCAN AVE APT A
ENCINITAS CA
92024-1791
US

V. Phone/Fax

Practice location:
  • Phone: 760-432-2462
  • Fax:
Mailing address:
  • Phone: 972-571-7464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: