Individual
BREANNA MICHELLE KENNON-LUJAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2085 RUSTIN AVE, RIVERSIDE, CA 92507-2498
(951) 955-8000
Mailing address
2085 RUSTIN AVE, RIVERSIDE, CA 92507-2498
(951) 955-8000
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
104702
CA
Other
Enumeration date
10/13/2022
Last updated
10/25/2023
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