Individual provider Active NPI

Kendra Ednacot, DOCTOR OF PHARMACY

  • Pharmacist
  • Northridge, CA
National Provider Identifier
1104361773
Registry record updated Jan 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
73992 Issued in CA
Practice address
8510 Balboa Blvd
Suite 150
Northridge, CA 91325-3583
Phone
(818) 672-4784
NPI assigned
Jan 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 73992 CA Primary

Addresses

Primary practice location

8510 Balboa Blvd
Suite 150
Northridge, CA 91325-3583

Mailing address

8510 Balboa Blvd
Suite 150
Northridge, CA 91325-3583
Phone (818) 672-4784

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
73992CAMDPharmacist

Interoperability endpoints

  • Direct secure messaging: kendra.fernandezednacot.p1@direct.lakeside.nextgenshare.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1483574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483574400000",
    "number": "1104361773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8510 BALBOA BLVD",
            "address_2": "SUITE 150",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913253583",
            "telephone_number": "818-672-4784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8510 BALBOA BLVD",
            "address_2": "SUITE 150",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913253583",
            "telephone_number": "818-672-4784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDNACOT",
        "first_name": "KENDRA",
        "credential": "DOCTOR OF PHARMACY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-05",
        "last_updated": "2017-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "73992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.