Individual
HAILEY KOURBAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1775 CHATSWORTH BLVD, SAN DIEGO, CA 92107-3709
(858) 988-2900
Mailing address
1775 CHATSWORTH BLVD, SAN DIEGO, CA 92107-3709
(858) 988-2900
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
100749
CA
235Z00000X
Speech-Language Pathologist
Primary
100749
MA
Other
Enumeration date
10/10/2024
Last updated
08/03/2026
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