Provider Demographics
NPI:1811769987
Name:SHEFCIK, GRACE
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:SHEFCIK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2465 SHORELINE DR
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-6264
Mailing Address - Country:US
Mailing Address - Phone:925-794-0746
Mailing Address - Fax:
Practice Address - Street 1:2465 SHORELINE DR
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-6264
Practice Address - Country:US
Practice Address - Phone:925-794-0746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-23
Last Update Date:2023-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist