Provider Demographics
NPI:1932939444
Name:VARTULI, KENDRA
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:
Last Name:VARTULI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8001 CRYSTALBROOK W
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78724-3354
Mailing Address - Country:US
Mailing Address - Phone:408-500-5562
Mailing Address - Fax:
Practice Address - Street 1:5900 BALCONES DR STE 242
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4200
Practice Address - Country:US
Practice Address - Phone:408-500-5562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX659931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical