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NPI Code Detail

MEDICARE: KATHLEEN BOMIE PAE

MEDICARE: KATHLEEN BOMIE PAE
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
1106S00000XBehavior TechnicianCA

General Provider Information

NPI Number : 1568304996
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN BOMIE PAE
Provider Business Mailing Address
First Line : 1130 BELL ST UNIT 1
Second Line :
City : SACRAMENTO
State : CA
Zip : 95825-3594
Country : US
Telephone Number : 213-255-8972
Fax Number :
Provider Business Practice Location Address
First Line : 2368 MARITIME DR
Second Line :
City : ELK GROVE
State : CA
Zip : 95758-3652
Country : US
Telephone Number : 916-580-1100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2026
Last Update Date : 06/02/2026

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Directions to “ KATHLEEN BOMIE PAE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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