Provider Demographics
NPI:1750041687
Name:SHAFER, KESLEY (AUD)
Entity type:Individual
Prefix:
First Name:KESLEY
Middle Name:
Last Name:SHAFER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:KESLEY
Other - Middle Name:
Other - Last Name:ARHART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2390 FARADAY AVE
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-7216
Mailing Address - Country:US
Mailing Address - Phone:760-860-2190
Mailing Address - Fax:
Practice Address - Street 1:2390 FARADAY AVE
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-7216
Practice Address - Country:US
Practice Address - Phone:760-860-2190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-20
Last Update Date:2025-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2201001788231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist