Kelly Renteria, is a
Case Manager/care Coordinator based in Crestline, California. Kelly Renteria is licensed to practice in * (Not Available) (license number ) and her current practice location is
24028 Lake Drive, Crestline, California. She can be reached at her office (for appointments etc.) via phone at
(909) 338-3222.
NPI number for Kelly Renteria is 1215512561 and her current mailing address is 13410 Barbara St, Moreno Valley, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1215512561.
Healthcare Provider's Profile
| Full Name | Kelly Renteria |
|---|
| Gender | Female |
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| Speciality | Case Manager/care Coordinator |
|---|
| Location | 24028 Lake Drive, Crestline, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1215512561
- Provider Enumeration Date: 03/17/2021
- Last Update Date: 07/12/2022
Medical Identifiers
Medical identifiers for Kelly Renteria such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1215512561 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Secondary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelly Renteria is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kelly Renteria,
13410 Barbara St,
Moreno Valley, CA 92553-8111
Ph: () - | Kelly Renteria,
24028 Lake Drive,
Crestline, CA 92325
Ph: (909) 338-3222 |
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