Healthcare Provider Details

I. General information

NPI: 1295214724
Provider Name (Legal Business Name): KYLEIGH DOMINQUE CUMMINGS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KYLEIGH DOMINQUE MCNABB

II. Dates (important events)

Enumeration Date: 08/06/2018
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17800 US HIGHWAY 18
APPLE VALLEY CA
92307-1221
US

IV. Provider business mailing address

15390 SITTING BULL ST
VICTORVILLE CA
92395-9645
US

V. Phone/Fax

Practice location:
  • Phone: 559-241-4385
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW137970
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: