Healthcare Provider Details

I. General information

NPI: 1891601522
Provider Name (Legal Business Name): MCCARTY INNOVATIVE SOLUTIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 13TH ST STE 600
OAKLAND CA
94612-2606
US

IV. Provider business mailing address

409 13TH ST STE 600
OAKLAND CA
94612-2606
US

V. Phone/Fax

Practice location:
  • Phone: 442-436-5520
  • 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: KRISTINE MARIE DAVIS
Title or Position: OPERATIONS COORDINATOR
Credential:
Phone: 442-436-5520