Provider Demographics
NPI:1982964417
Name:BIALKA, KATHERINE L (PA-C)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:L
Last Name:BIALKA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2721 OLIVE HWY STE 8
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95966-6115
Mailing Address - Country:US
Mailing Address - Phone:530-532-8071
Mailing Address - Fax:530-538-5640
Practice Address - Street 1:280 SIERRA COLLEGE DR STE 205
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5763
Practice Address - Country:US
Practice Address - Phone:530-477-7390
Practice Address - Fax:530-538-5640
Is Sole Proprietor?:No
Enumeration Date:2012-05-17
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA52032363LP2300X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
1982964417OtherFAMILY MEDICINE