Healthcare Provider Details

I. General information

NPI: 1972420214
Provider Name (Legal Business Name): ASCENDED ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3850 COCO AVE APT 5
LOS ANGELES CA
90008-1432
US

IV. Provider business mailing address

3850 COCO AVE APT 5
LOS ANGELES CA
90008-1432
US

V. Phone/Fax

Practice location:
  • Phone: 424-234-9780
  • Fax: 424-256-8148
Mailing address:
  • Phone: 424-234-9780
  • Fax: 424-256-8148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: KENNESHA FORREST
Title or Position: MANAGING DIRECTOR
Credential:
Phone: 424-234-9780