Provider Demographics
NPI:1790742070
Name:TRIBBEY, KATHRYN ANN (NP CNM)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ANN
Last Name:TRIBBEY
Suffix:
Gender:F
Credentials:NP CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 N SAN ANTONIO RD
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93110-1316
Mailing Address - Country:US
Mailing Address - Phone:805-681-5461
Mailing Address - Fax:
Practice Address - Street 1:116 S PALISADE DR
Practice Address - Street 2:SUITE 104
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-8904
Practice Address - Country:US
Practice Address - Phone:805-739-8710
Practice Address - Fax:805-739-8732
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA354173363LX0001X
CA4634363LX0001X
CA350176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
R91978Medicare UPIN