Healthcare Provider Details

I. General information

NPI: 1043121064
Provider Name (Legal Business Name): KEVIN ENGLE EDUCATION SPECIALIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1327 VIA TERRASSA
ENCINITAS CA
92024-5332
US

IV. Provider business mailing address

1327 VIA TERRASSA
ENCINITAS CA
92024-5332
US

V. Phone/Fax

Practice location:
  • Phone: 760-822-7644
  • Fax:
Mailing address:
  • Phone: 760-822-7644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: