Healthcare Provider Details

I. General information

NPI: 1104548619
Provider Name (Legal Business Name): KATHLEEN ELIZABETH ALBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2022
Last Update Date: 07/24/2024
Certification Date: 06/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 CASENTINI ST
SALINAS CA
93907-2299
US

IV. Provider business mailing address

200 CASENTINI ST
SALINAS CA
93907-2299
US

V. Phone/Fax

Practice location:
  • Phone: 831-758-9457
  • Fax:
Mailing address:
  • Phone: 831-758-9457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number124237
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: