Provider Demographics
NPI:1831486794
Name:KINDRED-LEBRON, LACRESHA DEANN
Entity Type:Individual
Prefix:MRS
First Name:LACRESHA
Middle Name:DEANN
Last Name:KINDRED-LEBRON
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 1:1932 JESSIE ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93305-4114
Mailing Address - Country:US
Mailing Address - Phone:661-395-6320
Mailing Address - Fax:661-323-3889
Practice Address - Street 1:1932 JESSIE ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93305-4114
Practice Address - Country:US
Practice Address - Phone:661-395-6320
Practice Address - Fax:661-323-3889
Is Sole Proprietor?:No
Enumeration Date:2011-06-29
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)