Provider Demographics
NPI:1639919707
Name:GERMINI, KAYLA MARIE
Entity type:Individual
Prefix:MS
First Name:KAYLA
Middle Name:MARIE
Last Name:GERMINI
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 1:2050 PEABODY RD STE 300
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-6695
Mailing Address - Country:US
Mailing Address - Phone:707-446-8600
Mailing Address - Fax:707-446-8100
Practice Address - Street 1:2050 PEABODY RD STE 300
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-6695
Practice Address - Country:US
Practice Address - Phone:707-446-8600
Practice Address - Fax:707-446-8100
Is Sole Proprietor?:No
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional