Provider Demographics
NPI:1295268530
Name:SCHNARR, KENNA BROOKE (DO, MS)
Entity type:Individual
Prefix:DR
First Name:KENNA
Middle Name:BROOKE
Last Name:SCHNARR
Suffix:
Gender:F
Credentials:DO, MS
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Other - First Name:
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Mailing Address - Street 1:11175 CAMPUS ST
Mailing Address - Street 2:COLEMAN PAVILION, ROOM #11105
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92350-1700
Mailing Address - Country:US
Mailing Address - Phone:909-651-5534
Mailing Address - Fax:
Practice Address - Street 1:11175 CAMPUS ST
Practice Address - Street 2:COLEMAN PAVILION, ROOM #11105
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92350-1700
Practice Address - Country:US
Practice Address - Phone:909-651-5534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA17325208D00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice