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

Kevin Kollenkark

Individual provider Certified Registered Nurse Anesthetist · NPI 1871767558

Kevin Kollenkark is a Certified Registered Nurse Anesthetist (CRNA) in Clovis, California. Qualified in 2008, 18 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
18
Licensed in
CA
In the registry since
2008
Specialties on file
2
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Practice location Address checks out

2755 Herndon Ave
Clovis, CA 93611-6800
Phone: (559) 324-4000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence NA3684 (CA)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence 3684 (CA)

Record details

NPI number1871767558
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 15, 2008
Last updated in NPPESDecember 1, 2021
Mailing addressPo Box 7096, Stockton, CA 95267-0096

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Clovis