Individual
DR. CASSANDRA ANN KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3300 RENNER DR, FORTUNA, CA 95540-3120
(707) 725-9832
(707) 725-7247
Mailing address
3300 RENNER DR, FORTUNA, CA 95540-3120
(707) 725-9832
(707) 725-7247
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G79397
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G793970
—
CA
Enumeration date
07/17/2006
Last updated
11/03/2021
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