Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kennyanna Jefferson

Individual provider Mental Health Counselor · NPI 1114540598

Kennyanna Jefferson is a Mental Health Counselor in Fontana, California. Practices as a sole proprietor and works from 2 locations. Licensed in California.

Licensed in
CA
In the registry since
2020
Specialties on file
3
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Practice location Address checks out

17053 Foothill Blvd
Fontana, CA 92335-3574
Phone: (909) 347-1300
Fax: (909) 347-1302
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 850 E Foothill Blvd, Rialto, CA 92376-5230 — (909) 420-9472

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 127688 (CA)
Mental Health Counselor Taxonomy 101YM0800X · Licence 102016 (CA)
Social Worker Taxonomy 104100000X · Licence ASW102016 (CA)

Record details

NPI number1114540598
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 20, 2020
Last updated in NPPESDecember 27, 2024
Certification dateDecember 27, 2024

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