Provider Demographics
NPI:1649158833
Name:LENTINI, KEVIN KYLE
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:KYLE
Last Name:LENTINI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1851 18TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN PABLO
Mailing Address - State:CA
Mailing Address - Zip Code:94806-4428
Mailing Address - Country:US
Mailing Address - Phone:707-679-8119
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 1021
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93062-1021
Practice Address - Country:US
Practice Address - Phone:707-679-8119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician