Basic Information
| Provider Information | |||||||||
| NPI: | 1760995708 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KILBY | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | BETH | ||||||||
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| OtherLastName: | SPOHN | ||||||||
| OtherFirstName: | SARAH | ||||||||
| OtherMiddleName: | BETH | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 7550 FOLSOM AUBURN RD APT 1508 | ||||||||
| Address2: | |||||||||
| City: | FOLSOM | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956306625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9255777442 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3498 GREEN VALLEY RD | ||||||||
| Address2: | |||||||||
| City: | RESCUE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956729625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5303918670 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/13/2017 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | CA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.