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NPI Code Detail

MEDICARE: KENDRA E. WILKINS MSW

MEDICARE: KENDRA E. WILKINS MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLCSW61783CA

General Provider Information

NPI Number : 1245357367
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENDRA E. WILKINS MSW
Provider Business Mailing Address
First Line : 5849 CROCKER ST
Second Line : UNIT K
City : LOS ANGELES
State : CA
Zip : 90003-1311
Country : US
Telephone Number : 323-406-5800
Fax Number : 323-233-2685
Provider Business Practice Location Address
First Line : 5849 CROCKER ST
Second Line : UNIT K
City : LOS ANGELES
State : CA
Zip : 90003-1311
Country : US
Telephone Number : 323-406-5800
Fax Number : 323-233-2685
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2007
Last Update Date : 01/04/2016

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