Provider Demographics
NPI:1346391117
Name:BILSON, KARI ALETHA
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:ALETHA
Last Name:BILSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:ALETHA
Other - Last Name:SMALLWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:337 S MARGALO ST
Mailing Address - Street 2:
Mailing Address - City:RIDGECREST
Mailing Address - State:CA
Mailing Address - Zip Code:93555-4533
Mailing Address - Country:US
Mailing Address - Phone:760-375-4357
Mailing Address - Fax:760-371-2446
Practice Address - Street 1:825 N DOWNS ST STE A
Practice Address - Street 2:
Practice Address - City:RIDGECREST
Practice Address - State:CA
Practice Address - Zip Code:93555-3371
Practice Address - Country:US
Practice Address - Phone:760-375-4357
Practice Address - Fax:760-371-2446
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator