Provider Demographics
NPI:1104294339
Name:KIONA FOUNDATION INC
Entity type:Organization
Organization Name:KIONA FOUNDATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAKISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:ND, RH
Authorized Official - Phone:209-229-2171
Mailing Address - Street 1:2334 M ST
Mailing Address - Street 2:SUITE 3511
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95344-2200
Mailing Address - Country:US
Mailing Address - Phone:209-725-3320
Mailing Address - Fax:209-725-3321
Practice Address - Street 1:357 W MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-4825
Practice Address - Country:US
Practice Address - Phone:209-725-3320
Practice Address - Fax:209-725-3321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable