Healthcare Provider Details

I. General information

NPI: 1013631340
Provider Name (Legal Business Name): KAYLA ALJANABI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2022
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 FORD ST
REDLANDS CA
92374-5400
US

IV. Provider business mailing address

295 89TH ST STE 306
DALY CITY CA
94015-1656
US

V. Phone/Fax

Practice location:
  • Phone: 909-389-8123
  • Fax:
Mailing address:
  • Phone: 877-264-6747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-90468
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: