Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 125-053414 | IL |
N | 207V00000X | Obstetrician & Gynecologist | A116919 | CA |
Y | 207VX0201X | Gynecologic Oncologist | A116919 | CA |
NPI | 1528229507 |
---|---|
Provider Name | Vanessa A Kennedy |
First Address | Sacramento, CA 95817-2307 |
Second Address | Sacramento, CA 95817-2307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2008 |
Last Update Date | 02/08/2017 |