Provider Demographics
NPI:1821786161
Name:KAYA MENTAL HEALTH & WELLNESS, A NURSING PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:KAYA MENTAL HEALTH & WELLNESS, A NURSING PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:MARITA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAILO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-652-2504
Mailing Address - Street 1:533 2ND ST
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-3558
Mailing Address - Country:US
Mailing Address - Phone:760-456-9552
Mailing Address - Fax:
Practice Address - Street 1:533 2ND ST
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-3558
Practice Address - Country:US
Practice Address - Phone:760-456-9552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-25
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty