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General NPI Number Information
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NPI Number | 1891364188
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Entity Type | Individual
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Provider Name | WESLEY KENDALL
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Gender | Male
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Dates
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Enumeration Date | 06/21/2021
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Last Update Date | 06/21/2021
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Provider Practice Location Address
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Address Line | 987 UNIVERSITY AVE STE 18
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City | LOS GATOS
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State | CA
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Zip | 95032-7640
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Country | US
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Telephone | 408-356-2800
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Fax |
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Provider Business Mailing Address
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Address Line | 2145 THE ALAMEDA
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City | SAN JOSE
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State | CA
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Zip | 95126-1141
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Country | US
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Telephone | 408-556-0110
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT300227
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License Number State | CA
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