Provider Demographics
NPI:1235382938
Name:HORNER, KENDRA DEE
Entity Type:Individual
Prefix:MRS
First Name:KENDRA
Middle Name:DEE
Last Name:HORNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1965 LIVE OAK BLVD
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-8828
Mailing Address - Country:US
Mailing Address - Phone:530-674-1885
Mailing Address - Fax:530-673-1810
Practice Address - Street 1:1965 LIVE OAK BLVD
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-8828
Practice Address - Country:US
Practice Address - Phone:530-674-1885
Practice Address - Fax:530-673-1810
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker