Provider Demographics
NPI:1568883833
Name:WELCHONS, KAYDEE
Entity Type:Individual
Prefix:
First Name:KAYDEE
Middle Name:
Last Name:WELCHONS
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 1:1904 S HORNE ST
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-6406
Mailing Address - Country:US
Mailing Address - Phone:760-757-8650
Mailing Address - Fax:760-439-9658
Practice Address - Street 1:1904 S HORNE ST
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-6406
Practice Address - Country:US
Practice Address - Phone:760-757-8650
Practice Address - Fax:760-439-9658
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-03
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM394176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife