Healthcare Provider Details

I. General information

NPI: 1013874122
Provider Name (Legal Business Name): KELAIYA JESLYN DOKES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27555 YNEZ RD STE 300
TEMECULA CA
92591-4678
US

IV. Provider business mailing address

30657 LANCELEAF WAY
MURRIETA CA
92563-1115
US

V. Phone/Fax

Practice location:
  • Phone: 951-694-0100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: