Provider Demographics
NPI:1215068515
Name:KENSHALO, JAMES W (LCSW)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:W
Last Name:KENSHALO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 SHERMAN DR
Mailing Address - Street 2:
Mailing Address - City:BENICIA
Mailing Address - State:CA
Mailing Address - Zip Code:94510-2626
Mailing Address - Country:US
Mailing Address - Phone:707-746-1777
Mailing Address - Fax:707-745-4800
Practice Address - Street 1:1440 MILIITARY AVE WEST
Practice Address - Street 2:SUITE 103
Practice Address - City:BENICIA
Practice Address - State:CA
Practice Address - Zip Code:94510-5811
Practice Address - Country:US
Practice Address - Phone:925-639-4868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW11066104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker