Provider Demographics
NPI:1619781911
Name:KENNEALLY ACUPUNCTURE, INC.
Entity type:Organization
Organization Name:KENNEALLY ACUPUNCTURE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST/ OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KENNEALLY
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:661-252-4100
Mailing Address - Street 1:23542 LYONS AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-5713
Mailing Address - Country:US
Mailing Address - Phone:818-383-0021
Mailing Address - Fax:
Practice Address - Street 1:23542 LYONS AVE STE 202
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-5713
Practice Address - Country:US
Practice Address - Phone:661-252-4100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty