Provider Demographics
NPI:1003970443
Name:FRAKA, KENDRA EVANS (MSW)
Entity type:Individual
Prefix:MRS
First Name:KENDRA
Middle Name:EVANS
Last Name:FRAKA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:KENDRA
Other - Middle Name:LEANNE
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2120
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95031-2120
Mailing Address - Country:US
Mailing Address - Phone:650-867-0998
Mailing Address - Fax:
Practice Address - Street 1:522 CAROBE CT
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-1412
Practice Address - Country:US
Practice Address - Phone:650-867-0998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
CA23782104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker