Individual provider · Type 1 NPI

Banchiamlak Kendrix

Student in an Organized Health Care Education/Training Program · Fontana, CA

NPI number 1790445104 Active

Practice location

13666 Lighthouse Ct
Fontana, CA 92336-3403

Call (909) 509-2214 Map

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400XNone listed
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1790445104

Banchiamlak Kendrix's National Provider Identifier is 1790445104, issued on Dec 27, 2021. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Fontana, CA. The record was last updated on Dec 27, 2021.