Healthcare Provider Details

I. General information

NPI: 1871072223
Provider Name (Legal Business Name): KATELYN CLOYD ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2018
Last Update Date: 08/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7472 LA JOLLA BLVD STE A
LA JOLLA CA
92037-5070
US

IV. Provider business mailing address

7472 LA JOLLA BLVD STE A
LA JOLLA CA
92037-5070
US

V. Phone/Fax

Practice location:
  • Phone: 619-980-8406
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number1003
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: