Provider Demographics
NPI:1750872503
Name:DANFORD-JOHN, KENDRA (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KENDRA
Middle Name:
Last Name:DANFORD-JOHN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 FAIR OAKS AVE STE 270
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91030-5801
Mailing Address - Country:US
Mailing Address - Phone:626-346-2455
Mailing Address - Fax:
Practice Address - Street 1:24853 ALESSANDRO BLVD STE 4
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-6102
Practice Address - Country:US
Practice Address - Phone:951-571-8518
Practice Address - Fax:877-778-9427
Is Sole Proprietor?:No
Enumeration Date:2018-05-27
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95008232363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily