Individual
MS. KAYCIE LYNN ELSASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
35325 DATE PALM DR STE 153F, CATHEDRAL CITY, CA 92234-7086
(937) 507-5816
Mailing address
35325 DATE PALM DR STE 153F, CATHEDRAL CITY, CA 92234-7086
(760) 537-1258
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
L9698
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L9698
DEPARTMENT OF CONSUMER AFFAIRS/ ELECTROLOGIST
CA
01
—
Z126827
DEPARTMENT OF CONSUMER AFFAIRS/ ESTHETICIAN
CA
Enumeration date
04/18/2022
Last updated
08/08/2023
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