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General NPI Number Information
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NPI Number | 1548700891
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Entity Type | Organization
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Legal Business Name | KENDRA PENSKI LICENSED CLINICAL SOCIAL WORKER INC
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Dates
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Enumeration Date | 03/06/2017
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 2254 SAN DIEGO AVE
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City | SAN DIEGO
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State | CA
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Zip | 92110-2944
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Country | US
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Telephone | 619-363-1920
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Fax | 619-363-4623
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Provider Business Mailing Address
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Address Line | PO BOX 371446
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City | SAN DIEGO
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State | CA
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Zip | 92137-1446
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Country | US
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Telephone | 619-363-1920
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Fax | 619-363-4623
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Authorized Official
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Title or Position | OWNER
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Name | KENDRA PENSKI
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Credential |
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Telephone | 619-363-1920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #8
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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 |
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