Healthcare Provider Details

I. General information

NPI: 1497633093
Provider Name (Legal Business Name): KENNA DENKERS
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2025
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 SHASTA DR
DAVIS CA
95616-6634
US

IV. Provider business mailing address

526 B ST
DAVIS CA
95616-3811
US

V. Phone/Fax

Practice location:
  • Phone: 530-757-5394
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: