Healthcare Provider Details

I. General information

NPI: 1144174590
Provider Name (Legal Business Name): KAELYN ECHAVE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2026
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 S INGLEWOOD AVE
INGLEWOOD CA
90301-2501
US

IV. Provider business mailing address

414 W 226TH ST
CARSON CA
90745-3609
US

V. Phone/Fax

Practice location:
  • Phone: 310-419-2700
  • Fax:
Mailing address:
  • Phone: 310-344-9221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: