=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134034598
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AMALI
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/18/2026
-----------------------------------------------------
Last Update Date | 08/18/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1330 ORANGE AVE STE 311
-----------------------------------------------------
City | CORONADO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92118-2949
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-782-3736
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1330 ORANGE AVE STE 311
-----------------------------------------------------
City | CORONADO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92118-2949
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-782-3736
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ASSOCIATE EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | TAYLOR KUGEL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 619-782-3736
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 373H00000X
-----------------------------------------------------
Taxonomy Name | Day Training/Habilitation Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------