Individual
KENNEDY KYALO KIOKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9183 SEVILLE LN, ATASCADERO, CA 93422-8871
(707) 596-2578
Mailing address
9315 RIVERA LN APT C, ATASCADERO, CA 93422-6826
(707) 596-2578
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
95330993
CA
164X00000X
Licensed Vocational Nurse
705786
CA
Other
Enumeration date
07/12/2021
Last updated
12/12/2024
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