KENDRICK WAYNE LOGAN - NPI 1053190975 - Rehabilitation Practitioner in Colton, CA

Q: What is Kendrick Logan's NPI number?

The NPI number for Kendrick Logan is 1053190975. It was assigned to this individual provider in the NPPES registry on September 28, 2023.

Q: What is Kendrick Logan's specialty?

The primary specialty registered for this NPI is Rehabilitation Practitioner with taxonomy code 225400000X.

Q: When was this NPI record last updated?

The NPPES record for Kendrick Logan was last updated on May 12, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Kendrick Wayne Logan NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENDRICK WAYNE LOGAN (NPI 1053190975) is an individual rehabilitation practitioner in Colton, California and active in the NPI registry since September 2023.

NPPES Registry Identity

NPI1053190975

Entity TypeIndividualMale

Primary Taxonomy225400000X

Provider Legal NameKENDRICK WAYNE LOGAN

Location Address1330 E COOLEY DRColton, CA 92324-3905

Mailing Address1330 E Cooley DrColton, CA 92324-3905 · (909) 580-3705

Phone(909) 580-3734

Sole ProprietorNo

Enumeration DateSeptember 28, 2023

Last NPPES UpdateMay 12, 2025

NPPES CertifiedMay 12, 2025

✔ NPI 1053190975 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyRehabilitation PractitionerRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code225400000X

Definition

A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity.

Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X

1330 E COOLEY DR, Colton, CA 92324

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. JUDITH A TATE LSW

Counselor