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Individual

LISA ANN KENNEDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SAC - CADTP #7774

Contact information

Practice address
1340 ARNOLD DR STE 200, MARTINEZ, CA 94553-4189
(925) 421-9107
Mailing address
1340 ARNOLD DR STE 200, MARTINEZ, CA 94553-4189
(925) 421-9107

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
373H00000X
Day Training/Habilitation Specialist
Primary
7774
CA

Other

Enumeration date
09/10/2015
Last updated
04/08/2026
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