Healthcare Provider Details

I. General information

NPI: 1538088364
Provider Name (Legal Business Name): WENDY (CASSIE) DEE KERR LEP #4378
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1046 STRATTON DR
VISTA CA
92083-4777
US

IV. Provider business mailing address

1046 STRATTON DR
VISTA CA
92083-4777
US

V. Phone/Fax

Practice location:
  • Phone: 949-278-2398
  • Fax:
Mailing address:
  • Phone: 949-278-2398
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number4378
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: