Healthcare Provider Details

I. General information

NPI: 1659297687
Provider Name (Legal Business Name): CAYLIN CAVAZOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44419 TOWN CENTER WAY STE E
PALM DESERT CA
92260-2704
US

IV. Provider business mailing address

2100 FRANKLIN ST STE 355
OAKLAND CA
94612-3140
US

V. Phone/Fax

Practice location:
  • Phone: 442-372-7224
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95039949
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: