Individual
DR. KYLENE KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.D.C.P.
Contact information
Practice address
23461 S POINTE DR STE 100, LAGUNA HILLS, CA 92653-1523
(949) 235-5769
Mailing address
22365 EL TORO RD # 415, LAKE FOREST, CA 92630-5053
(310) 574-2675
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY30815
CA
Other
Enumeration date
09/08/2014
Last updated
10/13/2021
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