MEDICARE: KIBO PSYCHIATRY AND WELLNESS CORP

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	363A00000X	Physician Assistant
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
3	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1336017995
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIBO PSYCHIATRY AND WELLNESS CORP

Provider Business Mailing Address
First Line	:	2829 TOWNSGATE RD STE 100
Second Line	:
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91361-3015
Country	:	US
Telephone Number	:	805-229-1525
Fax Number	:	818-337-1730

Provider Business Practice Location Address
First Line	:	2829 TOWNSGATE RD STE 100
Second Line	:
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91361-3015
Country	:	US
Telephone Number	:	805-229-1525
Fax Number	:	818-337-1730

Authorized Official
Title or Position	:	CO-OWNER
Name	:	DR. ASHLEY COVINGTON
Credential	:	MD
Telephone Number	:	805-229-1525

Provider Enumeration Date	:	10/27/2025
Last Update Date	:	03/24/2026

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Directions to “KIBO PSYCHIATRY AND WELLNESS CORP ” Practice Location

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