Provider Demographics
NPI:1487326369
Name:CHIRUMBOLO, CAYLEY (ND)
Entity type:Individual
Prefix:
First Name:CAYLEY
Middle Name:
Last Name:CHIRUMBOLO
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 N NEVADA ST
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-2423
Mailing Address - Country:US
Mailing Address - Phone:678-416-7319
Mailing Address - Fax:
Practice Address - Street 1:509 S CEDROS AVE STE D
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-2900
Practice Address - Country:US
Practice Address - Phone:678-416-7319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND1269175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath