Provider Demographics
NPI:1679355457
Name:SILLIGMAN, KASEY CATHERINE
Entity Type:Individual
Prefix:
First Name:KASEY
Middle Name:CATHERINE
Last Name:SILLIGMAN
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 1:2142A ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:VERNALIS
Mailing Address - State:CA
Mailing Address - Zip Code:95385-9704
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2142A ORCHARD RD
Practice Address - Street 2:
Practice Address - City:VERNALIS
Practice Address - State:CA
Practice Address - Zip Code:95385-9704
Practice Address - Country:US
Practice Address - Phone:209-914-5680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer