Healthcare Provider Details

I. General information

NPI: 1083369045
Provider Name (Legal Business Name): KELLY GRACE ARMSTRONG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2022
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 SATURN SKWY
REDDING CA
96002-2813
US

IV. Provider business mailing address

1155 GROUSE DR
REDDING CA
96003-5515
US

V. Phone/Fax

Practice location:
  • Phone: 530-224-4130
  • Fax:
Mailing address:
  • Phone: 530-780-6886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number40194
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: