Green, Kyla Diane

Green, Kyla Diane is an sole proprietor health care provider with primary practice located at 1 Saint Vincents Dr , San Rafael CA 94903-1504. She recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Other Service Providers / Community Health Worker, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Green, Kyla Diane can be contacted via phone (415) 507-2000.

Contact Information

Primary practice address
1 Saint Vincents Dr San Rafael CA 94903-1504
Phone: (415) 507-2000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Other Service Providers / Community Health Worker 172V00000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner 225400000X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1023601580
LBN Legal business name Green, Kyla Diane
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 16th, 2021
Last updated Mar 11th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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