Provider Demographics
NPI:1396626008
Name:KARABUSHIN, KATYA NICOLE
Entity type:Individual
Prefix:
First Name:KATYA
Middle Name:NICOLE
Last Name:KARABUSHIN
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 1:1517 EXPOSITION BLVD APT 17
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95815-5144
Mailing Address - Country:US
Mailing Address - Phone:303-214-8578
Mailing Address - Fax:
Practice Address - Street 1:3416 AMERICAN RIVER DR STE B
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95864-5753
Practice Address - Country:US
Practice Address - Phone:916-979-0497
Practice Address - Fax:916-972-9500
Is Sole Proprietor?:No
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP39821235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist