Provider Demographics
NPI:1679127401
Name:CUADRADO, KAYLYNN
Entity Type:Individual
Prefix:
First Name:KAYLYNN
Middle Name:
Last Name:CUADRADO
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 1:23151 VERDUGO DR
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-1349
Mailing Address - Country:US
Mailing Address - Phone:949-954-4422
Mailing Address - Fax:714-242-1611
Practice Address - Street 1:23151 VERDUGO DR
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-1349
Practice Address - Country:US
Practice Address - Phone:949-954-4422
Practice Address - Fax:714-242-1611
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program