Provider Demographics
NPI:1043364896
Name:BUDKA, KENDRA REA (NP)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:REA
Last Name:BUDKA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13678 SYCAMORE DR
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90601-3847
Mailing Address - Country:US
Mailing Address - Phone:562-907-2386
Mailing Address - Fax:
Practice Address - Street 1:11807 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90601-3941
Practice Address - Country:US
Practice Address - Phone:562-463-7742
Practice Address - Fax:562-463-0746
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA598693363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health