Healthcare Provider Details

I. General information

NPI: 1912640343
Provider Name (Legal Business Name): ASHLY KENDZIE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2022
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2960 W HORIZON RIDGE PKWY
HENDERSON NV
89052-4666
US

IV. Provider business mailing address

3680 N RANCHO DR
LAS VEGAS NV
89130-3180
US

V. Phone/Fax

Practice location:
  • Phone: 714-376-7333
  • Fax:
Mailing address:
  • Phone: 702-646-5437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: