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General NPI Number Information
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NPI Number | 1285538272
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Entity Type | Individual
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Provider Name | KAYLEIGH FENTERMACHER
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Gender | Female
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 1520 KIRKER PASS RD STE A
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City | CLAYTON
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State | CA
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Zip | 94517-1084
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Country | US
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Telephone | 925-567-5308
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Fax |
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Provider Business Mailing Address
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Address Line | 15320 MARSH CREEK RD
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City | CLAYTON
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State | CA
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Zip | 94517-9762
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 47273
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License Number State | CA
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