Healthcare Provider Details

I. General information

NPI: 1902138845
Provider Name (Legal Business Name): NATALIE J HIBBS MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2010
Last Update Date: 09/28/2022
Certification Date: 09/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 MISSION ST
SAN FRANCISCO CA
94110-5419
US

IV. Provider business mailing address

1919 ALAMEDA DE LAS PULGAS APT 77
SAN MATEO CA
94403-1243
US

V. Phone/Fax

Practice location:
  • Phone: 415-695-1400
  • Fax:
Mailing address:
  • Phone: 602-714-0600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP29941
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberTSLP6893
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: