Healthcare Provider Details

I. General information

NPI: 1750684924
Provider Name (Legal Business Name): LISAJO BERNSTEIN KAY MS, MS ED, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2010
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

585 WILLOW AVE
CHERRYLAND CA
94541-2424
US

IV. Provider business mailing address

4 CLIFTON WAY
SLINGERLANDS NY
12159-9306
US

V. Phone/Fax

Practice location:
  • Phone: 510-397-2524
  • Fax:
Mailing address:
  • Phone: 518-364-3294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP21015
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number011255
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: