| Madison Kennedy, Llc | |
|
971 41st St Unit 118 Oakland CA 94608-3997 | |
| (714) 398-9745 | |
| Not Available |
| Full Name | Madison Kennedy, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 971 41st St Unit 118, Oakland, California |
| Authorized Official Name and Position | Madison J Genovese (LPCC) |
| Authorized Official Contact | 7143989745 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Madison Kennedy, Llc 971 41st St Unit 118 Oakland CA 94608-3997 Ph: (714) 398-9745 | Madison Kennedy, Llc 971 41st St Unit 118 Oakland CA 94608-3997 Ph: (714) 398-9745 |
| NPI Number | 1356021422 |
|---|---|
| Provider Enumeration Date | 07/24/2023 |
| Last Update Date | 07/24/2023 |
| Certification Date | 07/22/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356021422 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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