Provider Demographics
NPI:1770289803
Name:KENDRA WILHELM LLC
Entity type:Organization
Organization Name:KENDRA WILHELM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILHELM
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:760-277-3497
Mailing Address - Street 1:4214 BEACH BLUFF RD
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-3606
Mailing Address - Country:US
Mailing Address - Phone:760-277-3497
Mailing Address - Fax:
Practice Address - Street 1:2382 FARADAY AVE
Practice Address - Street 2:STE 200, #29
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-7220
Practice Address - Country:US
Practice Address - Phone:619-363-3371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-31
Last Update Date:2025-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1720697584OtherINDIVIDUAL NPI