| Doctor Name: | KYLA CLAIRE IVEY |
| NPI Number: | 1154608248 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 155 Willowbrook Dr Ben Lomond, CA - 950059714 |
| Business Phone Number: | 8313365196 |
| Business Fax Number: | |
| Mailing Address: | 123 Library Ln, SANTA CRUZ |
| State: | CA |
| Postal Code: | 950622558 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 11/03/2011 |
| NPI Last Update Date: | 11/03/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |