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General NPI Number Information
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NPI Number | 1952018889
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Entity Type | Individual
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Provider Name | KAYCIE FAULKNER
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Gender | Female
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Dates
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Enumeration Date | 10/31/2022
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 566 S BRAND BLVD
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City | SAN FERNANDO
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State | CA
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Zip | 91340-4002
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Country | US
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Telephone | 818-898-0223
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Fax |
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Provider Business Mailing Address
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Address Line | 21545 CENTRE POINTE PKWY
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City | SANTA CLARITA
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State | CA
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Zip | 91350-2947
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Country | US
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Telephone | 661-259-9439
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 153011
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License Number State | CA
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