Kelleigh Ellison, M.S,, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

20140 Issued in CA

Practice address

948 Serpentine Dr
Redlands, CA 92373-6550

Phone

(562) 552-1821

NPI assigned

Dec 17, 2012

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 17, 2012.

{
    "created_epoch": "1355702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355702400000",
    "number": "1780920967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "948 SERPENTINE DR",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923736550",
            "telephone_number": "562-552-1821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "948 SERPENTINE DR",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923736550",
            "telephone_number": "562-552-1821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "KELLEIGH",
        "credential": "M.S,, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-17",
        "last_updated": "2012-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "20140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane M Eller-Boyko, RN,MSW,LCSW
• Carolina Ellerbrock, RN
• Thomas Brice Elliott, PH.D.
• Kate Ellis, RN
• Michelle Ellis, LVN
• Peter Elsissy, M.D.
• Bethany Skye Elton, LMFT
• Emad Ibrahim, MD, Inc.
• Emelly Rosspencer Licensed Marriage & Family Therapist Inc
• John Thomas Harlow Engelhardt, PSY.D.

• All providers in Redlands, CA
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.