High Desert Second Chance

Primary specialty

Voluntary or Charitable AgencyTaxonomy code 251V00000X

Legal business name

HIGH DESERT SECOND CHANCE

Practice address

16666 Smoke Tree St Ste B4
Hesperia, CA 92345-6100

Phone

(442) 267-4444

NPI assigned

May 14, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Christina P Keneti Kennedy

Title

President

Phone

(442) 267-4444

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nazario Bravo, CHW

  • Community Health Worker
  • Hesperia, CA
  • NPI 1568204964
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1715644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715644800000",
    "number": "1306695275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16666 SMOKE TREE ST STE B4",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923456100",
            "telephone_number": "442-267-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16666 SMOKE TREE ST STE B4",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923456100",
            "telephone_number": "442-267-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGH DESERT SECOND CHANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-14",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A",
        "authorized_official_last_name": "KENETI KENNEDY",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "442-267-4444",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Marie Hester, B.A.
• Charlisa Heyward, DNP, FNP-C
• High Desert Internal Medicine, Professional Corporation (High Desert Internal Medicine)
• High Desert Primary Care
• High Desert Primary Care (High Desert Primary Care - Hesperia)
• High Desert Specialty Group (High Desert Urgent Care)
• High Desert Specialty Group (High Desert Rehab Medicine)
• High Desert Specialty Group (High Desert Eye Care)
• High Desert Speech
• High Desert Speech and Language Pathology Center, Inc.

• Voluntary or Charitable Agency in Hesperia, CA
• Providers in Hesperia, CA by specialty
• Voluntary or Charitable Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.