Provider Demographics
NPI:1902138845
Name:HIBBS, NATALIE J (MS, CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:NATALIE
Middle Name:J
Last Name:HIBBS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 ALAMEDA DE LAS PULGAS APT 77
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-1243
Mailing Address - Country:US
Mailing Address - Phone:602-714-0600
Mailing Address - Fax:
Practice Address - Street 1:3401 MISSION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-5419
Practice Address - Country:US
Practice Address - Phone:415-695-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-03
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP29941235Z00000X
AZTSLP6893235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASP29941OtherDEPARTMENT OF CONSUMER AFFAIRS