Individual
KHYLE RAFAEL MANUEL III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
205 GRANADA ST, CAMARILLO, CA 93010-7715
(805) 482-9805
Mailing address
4913 LADERA VISTA DR, CAMARILLO, CA 93012-5319
(805) 758-4669
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
6750
CA
Other
Enumeration date
04/10/2025
Last updated
04/10/2025
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