Provider Demographics
NPI:1467249441
Name:BOURNE, KAILA
Entity type:Individual
Prefix:
First Name:KAILA
Middle Name:
Last Name:BOURNE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:KAILA
Other - Middle Name:
Other - Last Name:LOWERY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2250 BENTON DR
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-5350
Mailing Address - Country:US
Mailing Address - Phone:530-244-0117
Mailing Address - Fax:
Practice Address - Street 1:2250 BENTON DR
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-5350
Practice Address - Country:US
Practice Address - Phone:530-244-0117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator