Provider Demographics
NPI:1538904065
Name:OQUENDO, KAYLA EVON
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:EVON
Last Name:OQUENDO
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 1:2607 GUN POWDER LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-5507
Mailing Address - Country:US
Mailing Address - Phone:409-599-5829
Mailing Address - Fax:
Practice Address - Street 1:728 16TH AVE N
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77590-5736
Practice Address - Country:US
Practice Address - Phone:409-599-5829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst