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JOSEPH JENKINS
Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1053732032
Individual Registrant: JOSEPH JENKINS
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
28545 HIGHWAY 18 SKYFOREST, CA 92385-0578 US
Tel: 909-336-1800 Fax: 909-336-0990
Tel: 909-336-1800 Fax: 909-336-0990
Contact information for business:
PO BOX 578 SKYFOREST, CA 92385-0578 US
Tel: 909-336-1800 Fax: --
Tel: 909-336-1800 Fax: --
Registration Information:
NPI: 1053732032
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 101YA0400X | Behavioral Health & Social Service Providers Counselor Addiction (Substance Use Disorder) | CA |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
