Provider Demographics
NPI:1154516409
Name:KENDRICK, AMANDA N (PSYD)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:N
Last Name:KENDRICK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 E COLORADO BLVD STE 324
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2021
Mailing Address - Country:US
Mailing Address - Phone:818-839-1365
Mailing Address - Fax:626-385-4871
Practice Address - Street 1:595 E COLORADO BLVD STE 324
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2021
Practice Address - Country:US
Practice Address - Phone:818-839-1365
Practice Address - Fax:626-385-4871
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 23770103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical