Provider Demographics
NPI:1134763493
Name:GOODING, KENDRA H (LCSW)
Entity type:Individual
Prefix:MRS
First Name:KENDRA
Middle Name:H
Last Name:GOODING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6235 ALLENPORT WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-1230
Mailing Address - Country:US
Mailing Address - Phone:916-849-9412
Mailing Address - Fax:
Practice Address - Street 1:6235 ALLENPORT WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-1230
Practice Address - Country:US
Practice Address - Phone:916-849-9412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-30
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1216281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical