Healthcare Provider Details

I. General information

NPI: 1093249047
Provider Name (Legal Business Name): EMMALEE KNEAFSEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2017
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 YGNACIO VALLEY RD STE C103
WALNUT CREEK CA
94598-3382
US

IV. Provider business mailing address

1011 TALBOT AVE
ALBANY CA
94706-2331
US

V. Phone/Fax

Practice location:
  • Phone: 925-945-1474
  • Fax:
Mailing address:
  • Phone: 510-502-9160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP36082
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: