Healthcare Provider Details

I. General information

NPI: 1962900514
Provider Name (Legal Business Name): KAITLYN HENSLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2018
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5655 LINDERO CANYON RD STE 501
WESTLAKE VILLAGE CA
91362-7369
US

IV. Provider business mailing address

722 DANVERS CIR
NEWBURY PARK CA
91320-5419
US

V. Phone/Fax

Practice location:
  • Phone: 805-279-8351
  • Fax:
Mailing address:
  • Phone: 805-279-8351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number122337
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number137761
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: