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NPI Code Detail

MEDICARE: MS. GALE OLIVER KIBBY L.P.C.

MEDICARE: MS. GALE OLIVER KIBBY L.P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor2005038671MO

General Provider Information

NPI Number : 1164675435
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. GALE OLIVER KIBBY L.P.C.
Provider Business Mailing Address
First Line : 3870 ROSIN CT
Second Line : SUITE 130
City : SACRAMENTO
State : CA
Zip : 95834-1620
Country : US
Telephone Number : 916-363-1553
Fax Number :
Provider Business Practice Location Address
First Line : 3870 ROSIN CT
Second Line : SUITE 130
City : SACRAMENTO
State : CA
Zip : 95834-1620
Country : US
Telephone Number : 916-363-1553
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2008
Last Update Date : 02/17/2016

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