Individual
MRS. KENDRA E VILLASENOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
(209) 468-8861
Mailing address
PO BOX 4273, STOCKTON, CA 95204-0273
(209) 598-0067
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT 36449
CA
Other
Enumeration date
04/30/2012
Last updated
04/30/2012
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