Kendra Cavasos, LVN

Individual provider Active NPI Licensed Vocational Nurse · Exeter, CA

NPI 1710450010 · NPPES record last updated Jan 9, 2019

Key facts

NPI
1710450010
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Vocational Nurse 164X00000X
License
VN697003 (CA)
Practice address
1230 N Anderson Rd
Exeter, CA 93221-9674
Phone
(559) 594-4855
NPI assigned
Jan 9, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
VN697003CAMDLicensed Vocational Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Courage to Change, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X VN697003 CA Yes

Addresses

Primary practice location

1230 N Anderson Rd
Exeter, CA 93221-9674

Mailing address

1230 N Anderson Rd
Exeter, CA 93221-9674

Other providers in Exeter, CA

All providers in Exeter, CA · Licensed Vocational Nurse in California

Sources for this page

Verify at the official NPI Registry.