Healthcare Provider Details

I. General information

NPI: 1336089614
Provider Name (Legal Business Name): EMMA CORREIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6740 WILBUR AVE
RESEDA CA
91335-5179
US

IV. Provider business mailing address

4012 SUMMERSHADE LN
MOORPARK CA
93021-3015
US

V. Phone/Fax

Practice location:
  • Phone: 818-708-3533
  • Fax:
Mailing address:
  • Phone: 805-231-6433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: