Provider Demographics
NPI:1023621117
Name:SANGUINETTI, KAYLA YANAISA
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:YANAISA
Last Name:SANGUINETTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 SPLIT HOOVE CT
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-2449
Mailing Address - Country:US
Mailing Address - Phone:702-343-5956
Mailing Address - Fax:
Practice Address - Street 1:11 SPLIT HOOVE CT
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012-2449
Practice Address - Country:US
Practice Address - Phone:702-343-5956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant