MEDICARE: MASHAYLA KIZZEE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician		CA

General Provider Information

NPI Number	:	1144168956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MASHAYLA KIZZEE

Provider Business Mailing Address
First Line	:	8200 HAVEN AVE APT 9101
Second Line	:
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91730-6996
Country	:	US
Telephone Number	:	323-829-1465
Fax Number	:

Provider Business Practice Location Address
First Line	:	4688 ONTARIO MILLS PWKY
Second Line	:
City	:	ONTARIO
State	:	CA
Zip	:	91764
Country	:	US
Telephone Number	:	909-476-5747
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2026
Last Update Date	:	03/23/2026

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Directions to “ MASHAYLA KIZZEE ” Practice Location

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