Healthcare Provider Details

I. General information

NPI: 1457278533
Provider Name (Legal Business Name): SOPHIE A KEHL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3355 MISSION AVE STE 123
OCEANSIDE CA
92058-1327
US

IV. Provider business mailing address

3355 MISSION AVE STE 123
OCEANSIDE CA
92058-1327
US

V. Phone/Fax

Practice location:
  • Phone: 760-529-4975
  • Fax: 760-529-4761
Mailing address:
  • Phone: 760-529-4975
  • Fax: 760-529-4761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: