Provider Demographics
NPI:1104254671
Name:SIBO, GABY (PA-C)
Entity type:Individual
Prefix:
First Name:GABY
Middle Name:
Last Name:SIBO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:GABY
Other - Middle Name:
Other - Last Name:GALINDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1600 CREEKSIDE DR
Mailing Address - Street 2:SUITE 3800
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3444
Mailing Address - Country:US
Mailing Address - Phone:916-984-7830
Mailing Address - Fax:
Practice Address - Street 1:1600 CREEKSIDE DR
Practice Address - Street 2:SUITE 3800
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3444
Practice Address - Country:US
Practice Address - Phone:916-984-7830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-21
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51233363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant