Healthcare Provider Details

I. General information

NPI: 1467388439
Provider Name (Legal Business Name): KATIA BABITZKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

446 OLD NEWPORT BLVD STE 100
NEWPORT BEACH CA
92663-4246
US

IV. Provider business mailing address

2855 PINECREEK DR APT B202
COSTA MESA CA
92626-7451
US

V. Phone/Fax

Practice location:
  • Phone: 949-631-4327
  • Fax:
Mailing address:
  • Phone: 727-333-0755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number4167
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: