Healthcare Provider Details

I. General information

NPI: 1609655257
Provider Name (Legal Business Name): KELLY MAUREEN SCHEUFLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2023
Last Update Date: 09/25/2023
Certification Date: 09/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 E ROMIE LN
SALINAS CA
93901-4208
US

IV. Provider business mailing address

4560 MAPLE AVE UNIT 232
LA MESA CA
91941-6364
US

V. Phone/Fax

Practice location:
  • Phone: 831-424-8072
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number2256
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: