Provider Demographics
NPI:1407331648
Name:MATTHEWS, KENYA KEYONNA
Entity Type:Individual
Prefix:
First Name:KENYA
Middle Name:KEYONNA
Last Name:MATTHEWS
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 1:625 CHESTER DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-3917
Mailing Address - Country:US
Mailing Address - Phone:925-338-6098
Mailing Address - Fax:
Practice Address - Street 1:625 CHESTER DR
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-3917
Practice Address - Country:US
Practice Address - Phone:925-338-6098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-03
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty