Kelly Black, PMHNP-BC - Nurse Practitioner in Homeland, CA

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Kelly Black, PMHNP-BC is a Nurse Practitioner - Psychiatric/mental Health based in Homeland, California. Kelly Black is licensed to practice in California (license number 95024873) and her current practice location is 32205 Snyder Ln, Homeland, California. She can be reached at her office (for appointments etc.) via phone at (951) 623-7194.

NPI number for Kelly Black is 1912653536 and her current mailing address is 32205 Snyder Ln, Homeland, California. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1912653536.

Contact Information

Kelly Black, PMHNP-BC
32205 Snyder Ln,
Homeland, CA 92548-9600
(951) 623-7194
Not Available

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Provider's Profile

Full NameKelly Black
GenderFemale
SpecialityNurse Practitioner - Psychiatric/mental Health
Location32205 Snyder Ln, Homeland, California
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1912653536
  • Provider Enumeration Date: 02/22/2022
  • Last Update Date: 04/18/2023

Medical Identifiers

Medical identifiers for Kelly Black such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1912653536NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163WP0808XRegistered Nurse - Psychiatric/mental Health 56220 (California)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health 95024873 (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. Kelly Black 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 AddressPractice Location Address
Kelly Black, PMHNP-BC
32205 Snyder Ln,
Homeland, CA 92548-9600

Ph: (951) 623-7194		Kelly Black, PMHNP-BC
32205 Snyder Ln,
Homeland, CA 92548-9600

Ph: (951) 623-7194

Reviews and Comments


Nurse Practitioner Nurses in Homeland, CA

Mrs. Cynthia Maria Patino, FNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 25791 Drew Cir, Homeland, CA 92548
Phone: 951-467-0362    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.