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NPI Code Detail

MEDICARE: MRS. KYLE MELINDA TAYLOR-FREEMAN

MEDICARE: MRS. KYLE MELINDA TAYLOR-FREEMAN
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
1101YM0800XMental Health Counselor
2171M00000XCase Manager/Care Coordinator
3225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1700499621
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KYLE MELINDA TAYLOR-FREEMAN
Provider Business Mailing Address
First Line : 1011 CAMINO DEL RIO S STE 300
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-3567
Country : US
Telephone Number : 619-287-8225
Fax Number :
Provider Business Practice Location Address
First Line : 1011 CAMINO DEL RIO S STE 300
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-3567
Country : US
Telephone Number : 619-287-8225
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2020
Last Update Date : 06/16/2025

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