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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841324860 | NPPES |
| California | Other | CB279930 | MEDICARE |
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