Healthcare Provider Details

I. General information

NPI: 1982964417
Provider Name (Legal Business Name): KATHERINE L. BIALKA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2012
Last Update Date: 09/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 SIERRA COLLEGE DR STE 205
GRASS VALLEY CA
95945-5763
US

IV. Provider business mailing address

2721 OLIVE HWY STE 8
OROVILLE CA
95966-6115
US

V. Phone/Fax

Practice location:
  • Phone: 530-477-7390
  • Fax: 530-538-5640
Mailing address:
  • Phone: 530-532-8071
  • Fax: 530-538-5640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA52032
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberPA52032
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: