Gibson, Kelly A

Gibson, Kelly A is an individual health care provider with primary practice located at 4725 Hoen Ave , Santa Rosa CA 95405-9402. She recently has 5 registered licenses in different health care specialties including Speech, Language and Hearing Service Providers / Audiologist, Speech, Language and Hearing Service Providers / Assistive Technology Practitioner, Speech, Language and Hearing Service Providers / Assistive Technology Supplier, Speech, Language and Hearing Service Providers / Hearing Instrument Specialist, Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter. Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter is her primary health care specialty. Gibson, Kelly A can be contacted via phone (707) 542-1154.

Contact Information

Primary practice address
4725 Hoen Ave Santa Rosa CA 95405-9402
Phone: (707) 542-1154
Fax: (707) 542-4818
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist 231H00000X AU 2679 California
Speech, Language and Hearing Service Providers / Assistive Technology Practitioner 231HA2400X AU 2679 California
Speech, Language and Hearing Service Providers / Assistive Technology Supplier 231HA2500X AU 2679 California
Speech, Language and Hearing Service Providers / Hearing Instrument Specialist 237700000X
Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter 237600000X AU 2679 California

Profile Details

NPI number 1841324860
LBN Legal business name Gibson, Kelly A
Credentials AU.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2007
Last updated Sep 29th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841324860 NPPES
California Other CB279930 MEDICARE

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