Healthcare Provider Details

I. General information

NPI: 1003723321
Provider Name (Legal Business Name): KAYLA DILLARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 W VENTURA BLVD # 1066
CAMARILLO CA
93010-9134
US

IV. Provider business mailing address

317 W VENTURA BLVD # 1066
CAMARILLO CA
93010-9134
US

V. Phone/Fax

Practice location:
  • Phone: 805-250-0150
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86171615
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: