Provider Demographics
NPI:1295539930
Name:CHRISTIANSEN, KENDRA
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:
Last Name:CHRISTIANSEN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:471 23RD AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-3047
Mailing Address - Country:US
Mailing Address - Phone:616-405-5165
Mailing Address - Fax:
Practice Address - Street 1:471 23RD AVE APT 4
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-3047
Practice Address - Country:US
Practice Address - Phone:616-405-5165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-02
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95134010163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health