Provider Demographics
NPI:1972909778
Name:RANSDELL, KENNA NICOLE
Entity type:Individual
Prefix:MRS
First Name:KENNA
Middle Name:NICOLE
Last Name:RANSDELL
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 1:1221 E DYER RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-5600
Mailing Address - Country:US
Mailing Address - Phone:714-975-5202
Mailing Address - Fax:
Practice Address - Street 1:1221 E DYER RD
Practice Address - Street 2:SUITE 120
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-5600
Practice Address - Country:US
Practice Address - Phone:949-250-0488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-06
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health