Provider Demographics
NPI:1316323447
Name:JAMES, KENDRA JOELLE (NP-C, AGACNP-BC)
Entity type:Individual
Prefix:MS
First Name:KENDRA
Middle Name:JOELLE
Last Name:JAMES
Suffix:
Gender:F
Credentials:NP-C, AGACNP-BC
Other - Prefix:MRS
Other - First Name:KENDRA
Other - Middle Name:JOELLE
Other - Last Name:WEICHBRODT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 JAMES WAY
Mailing Address - Street 2:
Mailing Address - City:PISMO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93449-4973
Mailing Address - Country:US
Mailing Address - Phone:805-295-6594
Mailing Address - Fax:
Practice Address - Street 1:2 JAMES WAY
Practice Address - Street 2:
Practice Address - City:PISMO BEACH
Practice Address - State:CA
Practice Address - Zip Code:93449
Practice Address - Country:US
Practice Address - Phone:805-295-6594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-30
Last Update Date:2023-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95008969363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKNAOtherDO NOT HAVE AN IDENTIFICATION NUMBER YET