Provider Demographics
NPI:1700778909
Name:MATHEW, KENDRA NATASHA (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:NATASHA
Last Name:MATHEW
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3110 NOGALITOS STE 206
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78225-2338
Mailing Address - Country:US
Mailing Address - Phone:210-764-4113
Mailing Address - Fax:210-390-1550
Practice Address - Street 1:3110 NOGALITOS STE 206
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78225-2338
Practice Address - Country:US
Practice Address - Phone:210-764-4113
Practice Address - Fax:210-390-1550
Is Sole Proprietor?:No
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1193106363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1193106OtherAPRN