Provider Demographics
NPI:1043014525
Name:CARPENTER, KELSEY LEONOR
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:LEONOR
Last Name:CARPENTER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1547 MARIPOSA CT
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93906-2522
Mailing Address - Country:US
Mailing Address - Phone:831-235-3136
Mailing Address - Fax:
Practice Address - Street 1:1547 MARIPOSA CT
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906-2522
Practice Address - Country:US
Practice Address - Phone:831-235-3136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA307096225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist