Healthcare Provider Details

I. General information

NPI: 1033041330
Provider Name (Legal Business Name): NEURO SPEECH & VOICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1952 ASCOT DR
MORAGA CA
94556-1449
US

IV. Provider business mailing address

1952 ASCOT DR
MORAGA CA
94556-1449
US

V. Phone/Fax

Practice location:
  • Phone: 925-388-9144
  • 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 State

VIII. Authorized Official

Name: JUSTINE DOLAN
Title or Position: OWNER
Credential:
Phone: 925-388-9144