Provider Demographics
NPI:1164393336
Name:CACALDA, KAILENE GEONNA
Entity type:Individual
Prefix:MS
First Name:KAILENE GEONNA
Middle Name:
Last Name:CACALDA
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 1:7920 JASPENCE ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89166-5179
Mailing Address - Country:US
Mailing Address - Phone:702-727-7288
Mailing Address - Fax:
Practice Address - Street 1:9355 GRAY DUCK CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-6853
Practice Address - Country:US
Practice Address - Phone:702-272-3702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-12
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty