Provider Demographics
NPI:1235762634
Name:JAMES, KAILEE
Entity Type:Individual
Prefix:
First Name:KAILEE
Middle Name:
Last Name:JAMES
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 1:2415 MADERA CIR APT 12
Mailing Address - Street 2:
Mailing Address - City:PORT HUENEME
Mailing Address - State:CA
Mailing Address - Zip Code:93041-2025
Mailing Address - Country:US
Mailing Address - Phone:661-406-6685
Mailing Address - Fax:
Practice Address - Street 1:16650 SHERMAN WAY
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-3782
Practice Address - Country:US
Practice Address - Phone:818-785-0103
Practice Address - Fax:818-785-0145
Is Sole Proprietor?:No
Enumeration Date:2020-02-14
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner