Mr Peter Kennedy Jr, LCSW is a
Social Worker - Clinical based in Rancho Cucamonga, California. Mr Peter Kennedy Jr is licensed to practice in California (license number 82504) and his current practice location is
9500 Haven Ave, Rancho Cucamonga, California. He can be reached at his office (for appointments etc.) via phone at
(909) 433-1276.
NPI number for Mr Peter Kennedy Jr is 1821221250 and his current mailing address is 933 Bradbury Dr Se Ste 2222, Albuquerque, New Mexico. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1821221250.
Healthcare Provider's Profile
| Full Name | Mr Peter Kennedy Jr |
|---|
| Gender | Male |
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| Speciality | Social Worker - Clinical |
|---|
| Location | 9500 Haven Ave, Rancho Cucamonga, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1821221250
- Provider Enumeration Date: 09/02/2009
- Last Update Date: 05/22/2018
Medical Identifiers
Medical identifiers for Mr Peter Kennedy Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1821221250 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | M-08172 (New Mexico) | Secondary |
| 1041C0700X | Social Worker - Clinical | 82504 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Peter Kennedy Jr is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Peter Kennedy Jr, LCSW
933 Bradbury Dr Se Ste 2222,
Albuquerque, NM 87106-4375
Ph: (505) 272-5551 | Mr Peter Kennedy Jr, LCSW
9500 Haven Ave,
Rancho Cucamonga, CA 91730
Ph: (909) 433-1276 |
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