Provider Demographics
NPI:1679316376
Name:LENIX, KIANDRA M
Entity type:Individual
Prefix:
First Name:KIANDRA
Middle Name:M
Last Name:LENIX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10918 VILLA HERMOSA DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-9373
Mailing Address - Country:US
Mailing Address - Phone:661-654-8559
Mailing Address - Fax:
Practice Address - Street 1:10918 VILLA HERMOSA DR
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-9373
Practice Address - Country:US
Practice Address - Phone:661-654-8559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator