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General NPI Number Information
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NPI Number | 1508455767
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Entity Type | Individual
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Provider Name | KENYATTE PARKER
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Gender | Female
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Dates
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Enumeration Date | 01/12/2021
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 5325 BRODER BLVD
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City | DUBLIN
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State | CA
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Zip | 94568-3309
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Country | US
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Telephone | 925-803-7221
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Fax |
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Provider Business Mailing Address
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Address Line | 6955 FOOTHILL BLVD STE 300
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City | OAKLAND
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State | CA
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Zip | 94605-2421
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Country | US
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Telephone | 510-703-8864
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | IMF97132
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 150149
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License Number State | CA
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