Healthcare Provider Details

I. General information

NPI: 1275336448
Provider Name (Legal Business Name): KAILEY LYNN WARING AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2025
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13950 MILTON AVE STE 306
WESTMINSTER CA
92683-2939
US

IV. Provider business mailing address

215 CULVER BLVD #5132
PLAYA DEL REY CA
90296
US

V. Phone/Fax

Practice location:
  • Phone: 714-824-8150
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number153062
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: