Healthcare Provider Details

I. General information

NPI: 1700371374
Provider Name (Legal Business Name): FRANCESCA ANN KENFIELD QMHA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNA KENFIELD

II. Dates (important events)

Enumeration Date: 06/26/2018
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 1121
ROSEBURG OR
97470-0254
US

IV. Provider business mailing address

2210 N ELDORADO AVE
KLAMATH FALLS OR
97601-6418
US

V. Phone/Fax

Practice location:
  • Phone: 541-672-2691
  • Fax:
Mailing address:
  • Phone: 541-883-1030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: