Healthcare Provider Details

I. General information

NPI: 1518574524
Provider Name (Legal Business Name): KAYLEE FRAATS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KAYLEE HICKS

II. Dates (important events)

Enumeration Date: 09/24/2020
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 DYER ST
ORCUTT CA
93455-5300
US

IV. Provider business mailing address

3925 JUPITER AVE
LOMPOC CA
93436-1905
US

V. Phone/Fax

Practice location:
  • Phone: 805-938-8900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number37726
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: