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KEVIN RICHARD CERVANTES MD
NPI 1104409895
Student in an Organized Health Care Education/Training Program in Fontana, CA

Active since April 30, 2021PECOS Enrolled
17234 VALLEY BLVD, BUILDING A, FONTANA, CA 92335(909) 427-5679 Get Directions Write a Review

NPPES record last updated: December 6, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 6, 2021, Apr 30, 2021 (2 updates tracked since 2021).

About Kevin Richard Cervantes Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEVIN RICHARD CERVANTES MD (NPI 1104409895) is an individual student in an organized health care education/training program in Fontana, California and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104409895
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameKEVIN RICHARD CERVANTESCredential: MD
Location Address17234 VALLEY BLVD, BUILDING AFontana, CA 92335-6720
Mailing Address17234 Valley Blvd, Building AFontana, CA 92335-6720
Phone(909) 427-5679
Sole ProprietorNo
Enumeration DateApril 30, 2021
Last NPPES UpdateDecember 6, 20212 updates tracked since enumeration
NPPES CertifiedMarch 25, 2021
✔ NPI 1104409895 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
17234 VALLEY BLVD, Fontana, CA 92335
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kevin Richard Cervantes Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VENKATA SAITEJA PAMIDIMUKKALA DO
Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD
FONTANA, CA 92335
San Bernardino County (925) 819-4476
JAMI WANG DO
Psychiatry & Neurology (Psychiatry)
17234 VALLEY BLVD, BUILDING A
FONTANA, CA 92335
San Bernardino County (909) 427-5679
URVASHI SINGH
Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD, BUILDING A
FONTANA, CA 92335
San Bernardino County (909) 427-5679
GENISE URSIE JADE BROWNE MD
Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD, BUILDING A
FONTANA, CA 92335
San Bernardino County (407) 309-0538
DR. ALEXANDER JASON BRESSLER DO
Family Medicine
17234 VALLEY BLVD
FONTANA, CA 92335
San Bernardino County (909) 427-5084
DR. GREISHKA NICOLE CORDERO BAEZ MD
Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD, BUILDING A
FONTANA, CA 92335
San Bernardino County (909) 427-5679
DR. JING YA GAO DO
Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD
FONTANA, CA 92335
San Bernardino County (833) 574-2273
EMILY ISABEL MULDER
Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD, BUILDING A
FONTANA, CA 92335
San Bernardino County (833) 574-2273

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kevin Cervantes's NPI number?

The NPI number for Kevin Cervantes is 1104409895. It was assigned to this individual provider in the NPPES registry on April 30, 2021.

Where is Kevin Cervantes located?

Kevin Cervantes practices at 17234 Valley Blvd Building A, Fontana, CA 92335. The listed phone number is (909) 427-5679.

What is Kevin Cervantes's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Kevin Cervantes enrolled in Medicare?

Yes. Kevin Cervantes is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kevin Cervantes was last updated on December 6, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.