Healthcare Provider Details

I. General information

NPI: 1841925104
Provider Name (Legal Business Name): KILEY CUENE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2022
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 BIRCH ST STE 230E
NEWPORT BEACH CA
92660-2238
US

IV. Provider business mailing address

4101 BIRCH ST STE 230E
NEWPORT BEACH CA
92660-2238
US

V. Phone/Fax

Practice location:
  • Phone: 949-873-4617
  • Fax:
Mailing address:
  • Phone: 414-712-8194
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: