Provider Demographics
NPI:1811034283
Name:AVANT ORTIZ, KENDRA ALYSSA (ARNP-C)
Entity type:Individual
Prefix:MRS
First Name:KENDRA
Middle Name:ALYSSA
Last Name:AVANT ORTIZ
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14728 PLUMERIA CT STE B
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93314-8522
Mailing Address - Country:US
Mailing Address - Phone:407-449-6793
Mailing Address - Fax:
Practice Address - Street 1:4664 AMERICAN AVE STE B
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-4017
Practice Address - Country:US
Practice Address - Phone:661-800-9155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024666925363LF0000X
FLARNP9194715363LF0000X
AZAP4495363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health