Healthcare Provider Details

I. General information

NPI: 1427979103
Provider Name (Legal Business Name): KAYN CALHOUN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12421 HESPERIA RD
VICTORVILLE CA
92395-7703
US

IV. Provider business mailing address

3680 MONROE ST APT 504
RIVERSIDE CA
92504-6307
US

V. Phone/Fax

Practice location:
  • Phone: 760-245-5417
  • Fax:
Mailing address:
  • Phone: 951-858-5612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: