Individual
KENNETH HERRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
17043 MAIN ST, HESPERIA, CA 92345-6055
(760) 241-6666
(760) 243-2099
Mailing address
12550 HESPERIA RD # 101, VICTORVILLE, CA 92395-5873
(760) 381-7703
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95008084
CA
Other
Enumeration date
01/29/2018
Last updated
03/17/2018
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