Provider Demographics
NPI:1679444145
Name:REYNA, KAITLIN (RN, PHN, SCRN, CEOLD)
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:
Last Name:REYNA
Suffix:
Gender:F
Credentials:RN, PHN, SCRN, CEOLD
Other - Prefix:
Other - First Name:KATY
Other - Middle Name:
Other - Last Name:REYNA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, PHN, SCRN, CEOLD
Mailing Address - Street 1:513 ROSALIE WAY
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92019-1454
Mailing Address - Country:US
Mailing Address - Phone:858-264-6446
Mailing Address - Fax:
Practice Address - Street 1:513 ROSALIE WAY
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92019-1454
Practice Address - Country:US
Practice Address - Phone:858-264-6446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-16
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA849378163WC1500X, 163WH1000X, 163WN0800X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WH1000XNursing Service ProvidersRegistered NurseHospiceGroup - Multi-Specialty
No163WN0800XNursing Service ProvidersRegistered NurseNeuroscienceGroup - Multi-Specialty