Provider Demographics
NPI:1386074987
Name:KENFACK, ROPHINE MORIAH (DAOM)
Entity type:Individual
Prefix:DR
First Name:ROPHINE
Middle Name:MORIAH
Last Name:KENFACK
Suffix:
Gender:F
Credentials:DAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:469 W WINDSOR RD APT 2
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-1925
Mailing Address - Country:US
Mailing Address - Phone:818-397-1146
Mailing Address - Fax:
Practice Address - Street 1:469 W WINDSOR RD APT 2
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-1925
Practice Address - Country:US
Practice Address - Phone:818-397-1146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15796171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist