Kennyanna Jefferson, is a
Social Worker based in Fontana, California. Kennyanna Jefferson is licensed to practice in California (license number ASW102016) and her current practice location is
17053 Foothill Blvd, Fontana, California. She can be reached at her office (for appointments etc.) via phone at
(909) 347-1300.
NPI number for Kennyanna Jefferson is 1114540598 and her current mailing address is 850 E Foothill Blvd, Rialto, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1114540598.
Healthcare Provider's Profile
| Full Name | Kennyanna Jefferson |
|---|
| Gender | Female |
|---|
| Speciality | Social Worker |
|---|
| Location | 17053 Foothill Blvd, Fontana, 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: 1114540598
- Provider Enumeration Date: 05/20/2020
- Last Update Date: 12/06/2023
Medical Identifiers
Medical identifiers for Kennyanna Jefferson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1114540598 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | 102016 (California) | Secondary |
| 104100000X | Social Worker | ASW102016 (California) | 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. Kennyanna Jefferson 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 |
|---|
Kennyanna Jefferson,
850 E Foothill Blvd,
Rialto, CA 92376-5230
Ph: (909) 420-9472 | Kennyanna Jefferson,
17053 Foothill Blvd,
Fontana, CA 92335-3574
Ph: (909) 347-1300 |
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