Healthcare Provider Details

I. General information

NPI: 1992586507
Provider Name (Legal Business Name): ALLISON JOHANNA SHARP MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AVI JOHANNA SHARP MS, CCC-SLP

II. Dates (important events)

Enumeration Date: 10/10/2023
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 CHRISTENSEN CT
ALAMEDA CA
94502-7940
US

IV. Provider business mailing address

9 CHRISTENSEN CT
ALAMEDA CA
94502-7940
US

V. Phone/Fax

Practice location:
  • Phone: 916-622-9736
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number37734
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: