Provider Demographics
NPI:1497514681
Name:PHILOBOS, KAYLEA ANN (NBC-HWC)
Entity Type:Individual
Prefix:
First Name:KAYLEA
Middle Name:ANN
Last Name:PHILOBOS
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 E CLEVELAND ST
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE GROVE
Mailing Address - State:AR
Mailing Address - Zip Code:72753-3208
Mailing Address - Country:US
Mailing Address - Phone:626-848-4135
Mailing Address - Fax:
Practice Address - Street 1:1370 BREA BLVD STE 210
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-4128
Practice Address - Country:US
Practice Address - Phone:714-732-1773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach