Provider Demographics
NPI:1427875467
Name:FREY, KENDALL
Entity type:Individual
Prefix:
First Name:KENDALL
Middle Name:
Last Name:FREY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11024 PITTSBURG MINE RD
Mailing Address - Street 2:
Mailing Address - City:NEVADA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95959-3414
Mailing Address - Country:US
Mailing Address - Phone:831-227-5848
Mailing Address - Fax:
Practice Address - Street 1:417 BROAD ST STE D
Practice Address - Street 2:
Practice Address - City:NEVADA CITY
Practice Address - State:CA
Practice Address - Zip Code:95959-2444
Practice Address - Country:US
Practice Address - Phone:831-227-5848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-23
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula