Healthcare Provider Details

I. General information

NPI: 1821909144
Provider Name (Legal Business Name): KYLIE VINT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24450 VALENCIA BLVD APT 6202
SANTA CLARITA CA
91355-1813
US

IV. Provider business mailing address

24450 VALENCIA BLVD APT 6202
SANTA CLARITA CA
91355-1813
US

V. Phone/Fax

Practice location:
  • Phone: 702-756-9974
  • Fax:
Mailing address:
  • Phone: 702-756-9974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: