Kelsey Megan Ellison, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

39369 Issued in CA

Practice address

6536 Telegraph Ave Ste C101
Oakland, CA 94609-1192

Phone

(707) 641-4759

NPI assigned

Nov 21, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1732147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1992520175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 FAIR AVE",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949521219",
            "telephone_number": "858-334-9192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6536 TELEGRAPH AVE STE C101",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091192",
            "telephone_number": "707-641-4759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "KELSEY",
        "middle_name": "MEGAN",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-21",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "39369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• La Candra Virginia Ellis
• Patrick Ellis
• Senobia Frances Ellis
• Dimitrius Dean Ellisen
• Deone Ellison
• Mary Mae Ellison
• Tamara Abarca Ellsworth
• Russell Murray Ellyson, DO
• Ruby Elmer
• Jasmine Elmiari, PHARMD

• Speech-Language Pathologist in Oakland, CA
• Providers in Oakland, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; 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.