Provider Demographics
NPI:1104517697
Name:APOSTOL, KENDRA JUNE
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:JUNE
Last Name:APOSTOL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31475 AVENIDA DEL PADRE
Mailing Address - Street 2:
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-3098
Mailing Address - Country:US
Mailing Address - Phone:760-406-1978
Mailing Address - Fax:
Practice Address - Street 1:31475 AVENIDA DEL PADRE
Practice Address - Street 2:
Practice Address - City:CATHEDRAL CITY
Practice Address - State:CA
Practice Address - Zip Code:92234-3098
Practice Address - Country:US
Practice Address - Phone:760-406-1978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA77910225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist