Healthcare Provider Details

I. General information

NPI: 1285597716
Provider Name (Legal Business Name): KAITLYN KAI-YEE MAK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41550 ECLECTIC ST
PALM DESERT CA
92260-1967
US

IV. Provider business mailing address

41550 ECLECTIC ST
PALM DESERT CA
92260-1967
US

V. Phone/Fax

Practice location:
  • Phone: 760-299-5181
  • Fax: 877-205-6269
Mailing address:
  • Phone: 760-299-5181
  • Fax: 877-205-6269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: