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General NPI Number Information
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NPI Number | 1336017995
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Entity Type | Organization
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Legal Business Name | KIBO PSYCHIATRY AND WELLNESS CORP
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Dates
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Enumeration Date | 10/27/2025
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 2829 TOWNSGATE RD STE 100
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361-3015
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Country | US
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Telephone | 805-229-1525
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Fax | 818-337-1730
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Provider Business Mailing Address
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Address Line | 2829 TOWNSGATE RD STE 100
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361-3015
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Country | US
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Telephone | 805-229-1525
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Fax | 818-337-1730
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Authorized Official
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Title or Position | OWNER
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Name | ASHLEY COVINGTON
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Credential |
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Telephone | 805-229-1525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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