Healthcare Provider Details

I. General information

NPI: 1265024178
Provider Name (Legal Business Name): KENDALL NAGAI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2021
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 QUEBEC ST
DENVER CO
80230-6817
US

IV. Provider business mailing address

PO BOX 932184
ATLANTA GA
31193-2184
US

V. Phone/Fax

Practice location:
  • Phone: 904-618-3778
  • Fax:
Mailing address:
  • Phone: 904-895-5518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT.0009193
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: