Provider Demographics
NPI:1528852407
Name:ANDERSON, KENDRA (NBC-HWC)
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4129 STARKES GRADE RD
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-9204
Mailing Address - Country:US
Mailing Address - Phone:530-417-7694
Mailing Address - Fax:
Practice Address - Street 1:4129 STARKES GRADE RD
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-9204
Practice Address - Country:US
Practice Address - Phone:530-417-7694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach