Healthcare Provider Details

I. General information

NPI: 1821165622
Provider Name (Legal Business Name): BARBARA LYNN KENNEDY ND, FNP, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11301 WILSHIRE BLVD
LOS ANGELES CA
90073-1003
US

IV. Provider business mailing address

21917 LOPEZ ST
WOODLAND HILLS CA
91364-3121
US

V. Phone/Fax

Practice location:
  • Phone: 310-268-4038
  • Fax:
Mailing address:
  • Phone: 818-615-0886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number482522
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number7848
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number50542
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: