Healthcare Provider Details

I. General information

NPI: 1518826387
Provider Name (Legal Business Name): JENNIFER LEE KAIRIS M.S.ED,
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4283 EL CAJON BLVD STE 100
SAN DIEGO CA
92105-1289
US

IV. Provider business mailing address

4283 EL CAJON BLVD STE 100
SAN DIEGO CA
92105-1289
US

V. Phone/Fax

Practice location:
  • Phone: 619-521-1743
  • Fax:
Mailing address:
  • Phone: 619-521-1743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: