Healthcare Provider Details

I. General information

NPI: 1376319673
Provider Name (Legal Business Name): KENDRA JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2023
Last Update Date: 04/25/2026
Certification Date: 04/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44505 90TH ST W
LANCASTER CA
93536-7705
US

IV. Provider business mailing address

14129 BUCHER AVE
SYLMAR CA
91342-1442
US

V. Phone/Fax

Practice location:
  • Phone: 818-996-1051
  • Fax: 818-996-3051
Mailing address:
  • Phone: 818-290-5308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number733657
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: