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General NPI Number Information
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NPI Number | 1124931936
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Entity Type | Individual
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Provider Name | KENDRA MOBLEY
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Gender | Female
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Dates
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Enumeration Date | 09/23/2026
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Last Update Date | 09/23/2026
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Provider Practice Location Address
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Address Line | 1103 MAGNOLIA AVE APT 1
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City | GARDENA
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State | CA
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Zip | 90247-4386
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Country | US
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Telephone | 310-714-5902
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Fax |
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Provider Business Mailing Address
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Address Line | 1103 MAGNOLIA AVE APT 1
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City | GARDENA
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State | CA
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Zip | 90247-4386
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Country | US
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Telephone | 310-714-5902
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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 | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State | CA
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