Kenneth Lillard, is a
Community Health Worker based in San Bernardino, California. Kenneth Lillard is licensed to practice in * (Not Available) (license number ) and his current practice location is
572 N Arrowhead Ave, San Bernardino, California. He can be reached at his office (for appointments etc.) via phone at
(909) 266-2700.
NPI number for Kenneth Lillard is 1396870556 and his current mailing address is 256 E 8th St, Beaumont, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1396870556.
Healthcare Provider's Profile
| Full Name | Kenneth Lillard |
|---|
| Gender | Male |
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| Speciality | Community Health Worker |
|---|
| Location | 572 N Arrowhead Ave, San Bernardino, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1396870556
- Provider Enumeration Date: 02/21/2007
- Last Update Date: 06/12/2023
Medical Identifiers
Medical identifiers for Kenneth Lillard such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1396870556 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 172V00000X | Community Health Worker | (* (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. Kenneth Lillard 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 |
|---|
Kenneth Lillard,
256 E 8th St,
Beaumont, CA 92223-5904
Ph: (909) 266-2707 | Kenneth Lillard,
572 N Arrowhead Ave,
San Bernardino, CA 92401-1251
Ph: (909) 266-2700 |
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