Jefferson, Kennyanna

Jefferson, Kennyanna is an sole proprietor health care provider with primary practice located at 17053 Foothill Blvd , Fontana CA 92335-3574. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Social Worker is her primary health care specialty. Jefferson, Kennyanna can be contacted via phone (909) 347-1300.

Contact Information

Primary practice address
17053 Foothill Blvd Fontana CA 92335-3574
Phone: (909) 347-1300
Fax: (909) 347-1302
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 102016 California
Behavioral Health & Social Service Providers / Social Worker 104100000X ASW102016 California

Profile Details

NPI number 1114540598
LBN Legal business name Jefferson, Kennyanna
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 20th, 2020
Last updated Dec 6th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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