MEDICARE: KENDAL JOSEPH MOSES LMFT

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
1	106H00000X	Marriage & Family Therapist	131724	CA

General Provider Information

NPI Number	:	1245989227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENDAL JOSEPH MOSES LMFT

Provider Business Mailing Address
First Line	:	3960 W POINT LOMA BLVD STE H
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92110-5643
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1665 9TH AVE APT 4
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92101-2847
Country	:	US
Telephone Number	:	619-756-4928
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2022
Last Update Date	:	06/10/2025

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