Healthcare Provider Details

I. General information

NPI: 1831006485
Provider Name (Legal Business Name): COLLABORATIVE SPEECH THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2024 47TH AVE
OAKLAND CA
94601-4612
US

IV. Provider business mailing address

3630 HIGH ST UNIT 19128
OAKLAND CA
94619-6030
US

V. Phone/Fax

Practice location:
  • Phone: 510-545-3642
  • 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: KATHERINE SMARTT
Title or Position: PRESIDENT/CEO
Credential: MS CCC-SLP
Phone: 510-545-3642