MR. KEVIN EUGENE PUCKETT JR.
NPI 1619614807
Case Manager/Care Coordinator in Riverside, CA

Q: What is Kevin Puckett's NPI number?

The NPI number for Kevin Puckett is 1619614807. It was assigned to this individual provider in the NPPES registry on May 18, 2022.

Q: What is Kevin Puckett's specialty?

The primary specialty registered for this NPI is Case Manager/Care Coordinator with taxonomy code 171M00000X.

Q: When was this NPI record last updated?

The NPPES record for Kevin Puckett was last updated on May 20, 2022. 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.

Active since May 18, 2022

5425 SIERRA VISTA AVE, RIVERSIDE, CA 92505(951) 299-7645 Get Directions Write a Review

NPPES record last updated: May 20, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Mr. Kevin Eugene Puckett Jr. NPPES

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

MR. KEVIN EUGENE PUCKETT JR. (NPI 1619614807) is an individual case manager/care coordinator provider in Riverside, California and active in the NPI registry since May 2022.

NPPES Registry Identity

NPI1619614807

Entity TypeIndividualMale

Primary Taxonomy171M00000X

Provider Legal NameMR. KEVIN EUGENE PUCKETT JR.

Location Address5425 SIERRA VISTA AVERiverside, CA 92505-3113

Mailing Address3380 La Sierra AveRiverside, CA 92503-5271 · (951) 299-7645 · Fax (951) 299-7510

Phone(951) 299-7645

Sole ProprietorNo

Enumeration DateMay 18, 2022

Last NPPES UpdateMay 20, 2022

NPPES CertifiedMay 20, 2022

✔ NPI 1619614807 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCase Manager/Care CoordinatorOther Service Providers

Taxonomy Code171M00000X

Definition

A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.

5425 SIERRA VISTA AVE, Riverside, CA 92505

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