Provider Demographics
NPI:1134976491
Name:PAGUIO, KAYLA JUNE NENA
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:JUNE NENA
Last Name:PAGUIO
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 1:1322 E SHAW AVE STE 260
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-7914
Mailing Address - Country:US
Mailing Address - Phone:559-212-4377
Mailing Address - Fax:
Practice Address - Street 1:1322 E SHAW AVE STE 260
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-7914
Practice Address - Country:US
Practice Address - Phone:559-212-4377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-03
Last Update Date:2025-08-15
Deactivation Date:2025-06-16
Deactivation Code:
Reactivation Date:2025-07-31
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA1310681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program