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General NPI Number Information
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NPI Number | 1649194333
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Entity Type | Individual
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Provider Name | KYLE JOSEPH RILEY
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Gender | Male
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Dates
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Enumeration Date | 08/06/2026
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Last Update Date | 08/06/2026
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Provider Practice Location Address
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Address Line | 25411 SEA BLUFFS DR
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City | DANA POINT
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State | CA
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Zip | 92629-2190
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Country | US
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Telephone | 844-502-7996
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Fax |
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Provider Business Mailing Address
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Address Line | 2339 N GLENNWOOD ST
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City | ORANGE
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State | CA
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Zip | 92865-3509
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Country | US
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Telephone | 714-335-2113
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT28077
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License Number State | CA
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