Doctor profile · Federal record
Dr. Kenrick Bourne, PA-C
Physician Assistant · San Jacinto, CA
- NPI 1063690931
- 18 yrs on file
- Male
- Solo practice
- No sanctions
Practice & contact
- Primary practice
-
1695 S San Jacinto Ave Ste C
San Jacinto, CA 925835103
(951) 330-3100
fax (951) 380-8596 - Mailing address
-
1695 S San Jacinto Ave
San Jacinto, CA 925835103
Credentials & registration
- NPI registered
- February 2008 — 18 yrs on file
- Profile last updated
- October 4, 2024
- Specialty taxonomy
- 363A00000X — NUCC code
- State license (1)
- California #PA12018
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1063690931. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$1,656
Transactions
12
Manufacturers
5
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Boston Scientific Corporation | 7 | $1,555.31 | |
| Collegium Pharmaceutical, INC. | 2 | $40.64 | |
| Abbvie INC. | 1 | $30.24 | |
| Forte Bio-Pharma LLC | 1 | $15.76 | |
| Valinor Pharma, LLC | 1 | $13.98 |
By nature of payment
Frequently asked questions
What is Dr. Kenrick Bourne's medical specialty?
Dr. Kenrick Bourne practices Physician Assistant in San Jacinto, CA.
Where does Dr. Kenrick Bourne practice?
Dr. Kenrick Bourne practices at 1695 S San Jacinto Ave Ste C, San Jacinto, CA 925835103. Office phone: 9513303100.
What is Dr. Kenrick Bourne's NPI?
Dr. Kenrick Bourne's National Provider Identifier (NPI) is 1063690931, issued by NPPES.