Mr Sean Adrian Kruckenberg, LCSW is a
Social Worker - Clinical based in Rialto, California. Mr Sean Adrian Kruckenberg is licensed to practice in California (license number LCSW121455) and his current practice location is
850 E Foothill Blvd, Rialto, California. He can be reached at his office (for appointments etc.) via phone at
(909) 421-9380.
NPI number for Mr Sean Adrian Kruckenberg is 1871079665 and his current mailing address is 850 E Foothill Blvd, Rialto, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1871079665.
Healthcare Provider's Profile
| Full Name | Mr Sean Adrian Kruckenberg |
|---|
| Gender | Male |
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| Speciality | Social Worker - Clinical |
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| Location | 850 E Foothill Blvd, Rialto, 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: 1871079665
- Provider Enumeration Date: 07/14/2018
- Last Update Date: 03/20/2024
Medical Identifiers
Medical identifiers for Mr Sean Adrian Kruckenberg such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1871079665 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | 104512 (California) | Secondary |
| 104100000X | Social Worker | 104512 (California) | Secondary |
| 1041C0700X | Social Worker - Clinical | LCSW121455 (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. Mr Sean Adrian Kruckenberg 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 |
|---|
Mr Sean Adrian Kruckenberg, LCSW
850 E Foothill Blvd,
Rialto, CA 92376-5230
Ph: (909) 808-0967 | Mr Sean Adrian Kruckenberg, LCSW
850 E Foothill Blvd,
Rialto, CA 92376-5230
Ph: (909) 421-9380 |
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