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NPI Code Detail

MEDICARE: KATHLEEN EMMERT

MEDICARE: KATHLEEN EMMERT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1144177833
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN EMMERT
Provider Business Mailing Address
First Line : 1200 CONCORD AVE STE 185
Second Line :
City : CONCORD
State : CA
Zip : 94520-5006
Country : US
Telephone Number : 510-268-8120
Fax Number :
Provider Business Practice Location Address
First Line : 2301 E 20TH ST
Second Line :
City : FARMINGTON
State : NM
Zip : 87401-8905
Country : US
Telephone Number : 866-273-2451
Fax Number : 886-608-5560
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2026
Last Update Date : 03/24/2026

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Directions to “ KATHLEEN EMMERT ” Practice Location

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