Individual
KYLE FACCIANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2952 CEDAR ST, SAN DIEGO, CA 92102-1515
(619) 239-7370
Mailing address
2952 CEDAR ST, SAN DIEGO, CA 92102-1515
(619) 239-7370
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-ERUOPQ
CA
Other
Enumeration date
07/21/2026
Last updated
07/21/2026
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