Provider Demographics
NPI:1306555834
Name:LILLIBRIDGE, KATELYNN ANN (OTD)
Entity type:Individual
Prefix:DR
First Name:KATELYNN
Middle Name:ANN
Last Name:LILLIBRIDGE
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:MISS
Other - First Name:KATELYNN
Other - Middle Name:ANN
Other - Last Name:LIMEBURNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9300 VALLEY CHILDRENS PL
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93636-8761
Mailing Address - Country:US
Mailing Address - Phone:559-353-6800
Mailing Address - Fax:559-353-6813
Practice Address - Street 1:9300 VALLEY CHILDRENS PL
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93636-8761
Practice Address - Country:US
Practice Address - Phone:559-353-6800
Practice Address - Fax:559-353-6813
Is Sole Proprietor?:No
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23367225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist