Individual
DEANNA ELIZABETH KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MCPSS
Contact information
Practice address
31631 AUTO CENTER DR, LAKE ELSINORE, CA 92530-4523
(951) 461-5134
Mailing address
31631 AUTO CENTER DR, LAKE ELSINORE, CA 92530-4523
(951) 461-5134
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-FEHABW
CA
Other
Enumeration date
04/04/2025
Last updated
04/04/2025
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