Kayla Sibbaluca, ATC

Primary specialty

SpecialistTaxonomy code 174400000X

License

2000025463 Issued in CA

Practice address

201 Fair St
Petaluma, CA 94952-2516

Phone

(707) 778-4651

NPI assigned

Jun 30, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467244800000",
    "number": "1710338744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "652 POWDERHORN AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954072743",
            "telephone_number": "707-536-7888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 FAIR ST",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949522516",
            "telephone_number": "707-778-4651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIBBALUCA",
        "first_name": "KAYLA",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-30",
        "last_updated": "2016-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "2000025463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard A Shoninger
• Amy Shouse, LAC
• Diane Elizabeth Shrock, LMFT
• Julie L. Shulman, PH.D.
• Brian Kent Sibbald, D.D.S.
• Sierra Orthopedic Laboratory, Inc.
• Yesenia Sierra I
• Jasmine Marie Sigmann
• Mallissa Lynettee Silva
• Jill Ann Silverman, M.F.T.

• Specialist in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.