Provider Demographics
NPI:1194414516
Name:DOYLE, KAELYN (CADC-II (CA))
Entity type:Individual
Prefix:
First Name:KAELYN
Middle Name:
Last Name:DOYLE
Suffix:
Gender:F
Credentials:CADC-II (CA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1265
Mailing Address - Street 2:
Mailing Address - City:RIALTO
Mailing Address - State:CA
Mailing Address - Zip Code:92377-1265
Mailing Address - Country:US
Mailing Address - Phone:909-747-2529
Mailing Address - Fax:
Practice Address - Street 1:371 N WESTON PL
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-3006
Practice Address - Country:US
Practice Address - Phone:951-791-4083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor