DR. CHARLES DERENSBOUGH KENNEDY (NPI# 1942576111) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942576111 |
| Entity Type | Individual |
| Full Name | DR. CHARLES DERENSBOUGH KENNEDY |
| Credential | MD |
| Practice Address |
229 Sycamore Grove St Simi Valley CA 93065-7342 |
| Practice Telephone | 8052176724 |
| Practice Fax Number | 8052176724 |
| Mailing Telephone | 8052176724 |
| Mailing Fax Number | 8052176724 |
| Enumeration Date | 2012-03-31 |
| Last Update Date | 2012-03-31 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | G066894 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124455985 | Charles Kennedy Jr. | Specialist | 8454 Northview Pass, Fair Oak Ranch, TX 78015 | 2013-10-10 |
| 1902981624 | Charles A Kennedy | Social Worker | 4120 N 20th St Ste B, Phoenix, AZ 85016-6022 | 2006-10-25 |
| 1750485116 | Charles Reed Kennedy | Psychologist | 112 Holland Ave, Albany, NY 12208-3404 | 2006-09-07 |
| 1124477708 | Charles Kennedy | Student in an Organized Health Care Education/Training Program | 500 Cherry St, Bluefield, WV 24701-3306 | 2016-06-06 |
| 1467824425 | Charles T. Kennedy Jr. | Social Worker | 1309 S Linden Rd Ste C, Flint, MI 48532-3443 | 2015-10-29 |
| 1548583172 | Charles Reggie Kennedy Sr. | Orthotist | 777 Lakeland Dr, Jackson, MS 39216-4611 | 2010-03-10 |
| 1730320805 | Charles M Kennedy | Counselor | 171 Sw Court St, Dallas, OR 97338-3112 | 2009-03-18 |
| 1528260130 | Charles J Kennedy | Psychologist | 214 College Park Plz, Johnstown, PA 15904-2833 | 2007-06-05 |
| 1790896199 | Charles A. Kennedy | Dentist | 1000 Parkway Rd, South Charleston, WV 25309-9418 | 2006-08-31 |
| 1912984428 | Charles C Kennedy | Internal Medicine | 200 1st St Sw, Rochester, MN 55905-0001 | 2005-12-27 |
| Street Address |
229 SYCAMORE GROVE ST |
| City | SIMI VALLEY |
| State | CA |
| Zip Code | 93065-7342 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992312243 | Healing Hands Health Care Corp | Hospice Care, Community Based | 585 E. Los Angeles Ave, Suite H-b, Simi Valley, CA 93065 | 2020-09-29 |
| 1487261731 | Healing Love Health Care Services, Inc. | Hospice Care, Community Based | 585 E. Los Angeles Ave., Suite H - A, Simi Valley, CA 93065 | 2020-09-29 |
| 1528682499 | Nicole G. Nalbandian | Dentist | First Street Dental Group and Orthodontics, 1197 E Los Angeles Ave Ste E, Simi Valley, CA 93065 | 2020-06-05 |
| 1316597230 | K-clear Nursing Inc | Family Medicine | 1822 Springgate Ln Unit G., Simi Valley, CA 93065 | 2019-09-12 |
| 1780242313 | Valencia Medical Inc | Family Medicine | 1526 Patricia Ave, Unit 159, Simi Valley, CA 93065 | 2019-05-29 |
| 1962920553 | Taylor Pediatrics | Pediatrics | 2755 Alamo Street Ste: 201, Simi Valley, CA 93065 | 2017-09-02 |
| 1487181301 | Renee Brooks | Marriage & Family Therapist | Ventura County Behavioral Health, 1227 E. Los Angeles Ave., Simi Valley, CA 93065 | 2017-05-23 |
| 1225577208 | Amanda Blake | Dietitian, Registered | 2592 Victoria St, Simi Valley, CA 93065 | 2017-02-23 |
| 1245778364 | Tyler James Arauza | Behavior Technician | 2856 Thicket Pl., Simi Valley, CA 93065 | 2017-02-09 |
| 1992169007 | Sahar Yaftaly | Dentist | 2045 Royal Ave Ste 109, Simi Valley, CA 93065 | 2016-04-06 |
| Find all providers in zip 93065 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457773913 | Edward Posvar | Internal Medicine | 485 Vineyard Dr, Simi Valley, CA 93065-8244 | 2014-01-16 |
| 1689826661 | Jasbir Singh Tiwana | Internal Medicine | 1172 Swallow Ln, Simi Valley, CA 93065-3154 | 2008-10-21 |
| 1164611075 | Gurdip Singh Flora | Internal Medicine | 1172 Swallow Lane, Simi Valley, CA 93065 | 2007-10-16 |
| 1609915768 | Harris Wasser | Internal Medicine | 2950 N Sycamore Dr #200, Simi Valley, CA 93065 | 2007-02-05 |
| 1306905716 | William L. Matzner | Internal Medicine | 143 Parrot Ln, Simi Valley, CA 93065-3151 | 2006-12-08 |
| 1871682096 | Simi Health Center A Medical Corp | Internal Medicine | 1350 E Los Angeles Ave, Simi Valley, CA 93065-2898 | 2006-10-12 |
| 1215049374 | Chandrashekhar R Joshi | Internal Medicine | 1350 Los Angeles Avenue, Simi Valley, CA 93065-2898 | 2006-08-31 |
| 1538199765 | Farridah Shafiee | Internal Medicine | 2655 1st St Ste 325, Simi Valley, CA 93065-1581 | 2006-07-04 |
| 1346218658 | Mojgan Makhsoosi | Internal Medicine | 2750 Sycamore Dr Ste 209, Simi Valley, CA 93065-1500 | 2006-03-10 |
| 1619960705 | William Ang Lee | Internal Medicine | 2755 Alamo St Ste 101, Simi Valley, CA 93065 | 2005-08-24 |
| Find all providers in SIMI VALLEY | ||||
| City | SIMI VALLEY |
| Zip Code | 93065 |
Please comment or provide details below to improve the information on DR. CHARLES DERENSBOUGH KENNEDY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.