Provider Demographics
NPI:1457629495
Name:KENNA, AARON ANDREW (DC)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:ANDREW
Last Name:KENNA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6370 LUSK BLVD
Mailing Address - Street 2:STE. F205
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-2753
Mailing Address - Country:US
Mailing Address - Phone:619-631-5433
Mailing Address - Fax:
Practice Address - Street 1:6370 LUSK BLVD
Practice Address - Street 2:F205
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-2753
Practice Address - Country:US
Practice Address - Phone:619-631-5433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-06
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32051111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor