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MR. KENNETH PARK
NPI 1255768974
Social Worker - Clinical in San Bernardino, CA

Active since September 27, 2013
2372 STERLING AVE, SAN BERNARDINO, CA 92404(310) 421-9405 Get Directions Write a Review

NPPES record last updated: February 17, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Kenneth Park NPPES

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

MR. KENNETH PARK (NPI 1255768974) is an individual clinical provider in San Bernardino, California, licensed in California (68555) and active in the NPI registry since September 2013.

NPPES Registry Identity

NPI1255768974
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMR. KENNETH PARK
Location Address2372 STERLING AVESan Bernardino, CA 92404-4624
Mailing Address2372 Sterling AveSan Bernardino, CA 92404-4624 · (310) 421-9405
Phone(310) 421-9405
Sole ProprietorNo
Enumeration DateSeptember 27, 2013
Last NPPES UpdateFebruary 17, 2017
✔ NPI 1255768974 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in CA · 68555
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.
2372 STERLING AVE, San Bernardino, CA 92404
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Other Identifiers 1

OtherASW #68555CA · Board Of Behavioral Sciences

Other Providers at the Same Location NPPES 4

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

COUNTY OF SAN BERNARDINO
Clinic/Center (Mental Health (Including Community Mental Health Center))
2372 STERLING AVE
SAN BERNARDINO, CA 92404
San Bernardino County (909) 422-8029
CAJON MEDICAL GROUP PC
Internal Medicine
2372 STERLING AVE
SAN BERNARDINO, CA 92404
San Bernardino County (909) 735-2446
DR. JUAN VELASQUEZ M.D.
Family Medicine
2372 STERLING AVE
SAN BERNARDINO, CA 92404
San Bernardino County (909) 422-8029
INLAND PSYCHIATRIC MEDICAL GROUP, INC.
Psychiatry & Neurology (Psychiatry)
2372 STERLING AVE
SAN BERNARDINO, CA 92404
San Bernardino County (909) 887-6222

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 Kenneth Park's NPI number?

The NPI number for Kenneth Park is 1255768974. It was assigned to this individual provider in the NPPES registry on September 27, 2013.

Where is Kenneth Park located?

Kenneth Park practices at 2372 Sterling Ave, San Bernardino, CA 92404. The listed phone number is (310) 421-9405.

What is Kenneth Park's specialty?

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

When was this NPI record last updated?

The NPPES record for Kenneth Park was last updated on February 17, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.