Provider Demographics
NPI:1518567734
Name:BAREFIELD, KYLE MICHAEL (OT-C)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:MICHAEL
Last Name:BAREFIELD
Suffix:
Gender:M
Credentials:OT-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 SANTA FE DR STE 301
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-5140
Mailing Address - Country:US
Mailing Address - Phone:760-633-4700
Mailing Address - Fax:760-635-4350
Practice Address - Street 1:320 SANTA FE DR STE 301
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5140
Practice Address - Country:US
Practice Address - Phone:760-633-4700
Practice Address - Fax:760-635-4350
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA246ZX2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZX2200XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherOrthopedic Assistant