Mykell Gray

Individual provider Active NPI Speech-Language Assistant · Grand Terrace, CA

NPI 1669327656 · NPPES record last updated Mar 4, 2026

Key facts

NPI
1669327656
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Assistant 2355S0801X
License
3291 (CA)
Practice address
22365 Barton Rd Ste 104
Grand Terrace, CA 92313-5037
Phone
(909) 824-2899
NPI assigned
Mar 4, 2026
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Five Oaks Speech Therapy Services PC Past
since Jan 29, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 3291 CA Yes

Addresses

Primary practice location

22365 Barton Rd Ste 104
Grand Terrace, CA 92313-5037

Mailing address

22365 Barton Rd Ste 104
Grand Terrace, CA 92313-5037
Phone (909) 824-2899

Other providers in Grand Terrace, CA

All providers in Grand Terrace, CA · Speech-Language Assistant in California

Sources for this page

Verify at the official NPI Registry.