Healthcare Provider Details

I. General information

NPI: 1073442992
Provider Name (Legal Business Name): KRISTIN ROSE MERKEL MA, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2026
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 LA JOLLA ST
WEST SACRAMENTO CA
95691-4947
US

IV. Provider business mailing address

1575 COIT PL
WEST SACRAMENTO CA
95691-5159
US

V. Phone/Fax

Practice location:
  • Phone: 916-375-0960
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number21805
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: