=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275336448
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KAILEY LYNN WARING AMFT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/31/2025
-----------------------------------------------------
Last Update Date | 03/31/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13950 MILTON AVE STE 306
-----------------------------------------------------
City | WESTMINSTER
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92683-2939
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-824-8150
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 215 CULVER BLVD #5132
-----------------------------------------------------
City | PLAYA DEL REY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90296
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 153062
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------