Provider Demographics
NPI:1407421068
Name:DANIELS, KAYLEY (RN)
Entity type:Individual
Prefix:
First Name:KAYLEY
Middle Name:
Last Name:DANIELS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7567 COLBERT DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO MURIETA
Mailing Address - State:CA
Mailing Address - Zip Code:95683-8802
Mailing Address - Country:US
Mailing Address - Phone:248-915-8434
Mailing Address - Fax:323-866-1881
Practice Address - Street 1:22320 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-2885
Practice Address - Country:US
Practice Address - Phone:888-428-3223
Practice Address - Fax:323-866-1881
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2025-11-15
Deactivation Date:2025-03-30
Deactivation Code:
Reactivation Date:2025-07-22
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program