Healthcare Provider Details

I. General information

NPI: 1518861319
Provider Name (Legal Business Name): OAK KNOLL SPEECH THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4248 OAK KNOLL DR
CARMICHAEL CA
95608-2644
US

IV. Provider business mailing address

4248 OAK KNOLL DR
CARMICHAEL CA
95608-2644
US

V. Phone/Fax

Practice location:
  • Phone: 916-546-8853
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KRISTY BRADY
Title or Position: OWNER/ SPEECH LANGUAGE PATHOLOGIST
Credential:
Phone: 916-546-8853