KENNYANNA JEFFERSON
NPI 1114540598
Social Worker - Clinical in Fontana, CA

Q: What is Kennyanna Jefferson's NPI number?

The NPI number for Kennyanna Jefferson is 1114540598. It was assigned to this individual provider in the NPPES registry on May 20, 2020.

Q: What is Kennyanna Jefferson's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Active since May 20, 2020PECOS Enrolled

17053 FOOTHILL BLVD, FONTANA, CA 92335(909) 347-1300(909) 347-1302 Get Directions Write a Review

NPPES record last updated: December 27, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 27, 2024, Dec 6, 2023, Jul 8, 2021 and 1 more (4 updates tracked since 2020).

On this page

About Kennyanna Jefferson NPPES

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

KENNYANNA JEFFERSON (NPI 1114540598) is an individual clinical provider in Fontana, California, licensed in California (127688) and active in the NPI registry since May 2020. She is enrolled in Medicare PECOS and maintains a secondary practice location in Rialto.

NPPES Registry Identity

NPI1114540598

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameKENNYANNA JEFFERSON

Location Address17053 FOOTHILL BLVDFontana, CA 92335-3574

Mailing Address850 E Foothill BlvdRialto, CA 92376-5230 · (909) 420-9472

Phone(909) 347-1300

Fax(909) 347-1302

Sole ProprietorYes

Enumeration DateMay 20, 2020

Last NPPES UpdateDecember 27, 20244 updates tracked since enumeration

NPPES CertifiedDecember 27, 2024

✔ NPI 1114540598 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in CA · 127688

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 102016 (CA)

Also ListedSocial WorkerTaxonomy 104100000X · License ASW102016 (CA)

17053 FOOTHILL BLVD, Fontana, CA 92335

Open in Google Maps ↗

Secondary Practice Location 1

Location 1850 E Foothill BlvdRialto, CA 92376-5230 · Phone (909) 420-9472

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kennyanna Jefferson 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92335 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $59.60 – $179.42

Typical copayment $0.00 (range $14.90 – $44.85)

Most-billed visit code NA

Established Patient

$74.08 typical visit price

range $19.37 – $146.42

Typical copayment $18.52 (range $4.84 – $36.60)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 18

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

EMMA NOELLE SCHNEIDER

Rehabilitation Practitioner