Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. KENRICK CARLYLE BOURNE, PA-C
Active Sole ProprietorMR. KENRICK CARLYLE BOURNE, PA-C is a Physician Assistant healthcare provider located in SAN JACINTO, California. NPI 1063690931 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · SAN JACINTO, CA
Registration Details
- NPI Number
- 1063690931
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 4, 2008 (18.493686466182 yrs)
- Last Updated
- Oct 4, 2024
- License
-
PA12018 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1695 S SAN JACINTO AVE STE CSAN JACINTO, CA, 925835103Browse CA providers · Browse ZIP 92583
- Phone
- 9513303100
- Fax
- 9513808596
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in SAN JACINTO, CA
| Name | Credential | NPI |
|---|---|---|
| SARA ELIZABETH BARNES | M.S, P.A.-C. | 1518180702 |
| NIKOLAY NIKOLAYEVICH LOBODA | PA | 1316252356 |
| TAIWO OLAWUYI | — | 1508739681 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.