Provider Demographics
NPI:1326552498
Name:KORNHUBER, KATHARINA
Entity Type:Individual
Prefix:
First Name:KATHARINA
Middle Name:
Last Name:KORNHUBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 UPPER CIR UNIT B
Mailing Address - Street 2:
Mailing Address - City:CARMEL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93924-9737
Mailing Address - Country:US
Mailing Address - Phone:917-846-9534
Mailing Address - Fax:
Practice Address - Street 1:65 UPPER CIR UNIT B
Practice Address - Street 2:
Practice Address - City:CARMEL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93924-9737
Practice Address - Country:US
Practice Address - Phone:917-846-9534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-27
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23247235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist