Individual
KELLY C GENDOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2641 HAMNER AVE UNIT 106110, NORCO, CA 92860-3636
(626) 536-4834
Mailing address
414 E SAN BERNARDINO RD, COVINA, CA 91723-1704
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
7380
CA
Other
Enumeration date
01/16/2026
Last updated
01/16/2026
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