Healthcare Provider Details

I. General information

NPI: 1447925573
Provider Name (Legal Business Name): KAYLA DARDEN PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2021
Last Update Date: 07/13/2023
Certification Date: 07/13/2023
Deactivation Date: 08/17/2021
Reactivation Date: 09/30/2021

III. Provider practice location address

11840 S LA CIENEGA BLVD
HAWTHORNE CA
90250-3459
US

IV. Provider business mailing address

21005 REYNOLDS DR APT 11
TORRANCE CA
90503-9036
US

V. Phone/Fax

Practice location:
  • Phone: 424-269-3400
  • Fax: 310-882-5451
Mailing address:
  • Phone: 714-600-4981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License Number300530
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number300530
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: