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General NPI Number Information
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NPI Number | 1063096816
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Entity Type | Individual
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Provider Name | UNIESIA KENDRA GAY
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Gender | Female
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Dates
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Enumeration Date | 05/07/2021
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Last Update Date | 05/07/2021
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Provider Practice Location Address
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Address Line | 16501 WALNUT ST STE 12
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City | HESPERIA
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State | CA
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Zip | 92345-3684
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Country | US
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Telephone | 760-508-4571
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2777
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City | APPLE VALLEY
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State | CA
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Zip | 92307-0053
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Country | US
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Telephone | 760-508-4571
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | CA
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