Healthcare Provider Details

I. General information

NPI: 1699429209
Provider Name (Legal Business Name): KATE HAGGARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2022
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2520 STANWELL DR STE 210
CONCORD CA
94520-4858
US

IV. Provider business mailing address

311 MEADOW LN
MONROVIA CA
91016-1805
US

V. Phone/Fax

Practice location:
  • Phone: 510-250-9199
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number6069
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: