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NPI Code Detail

MEDICARE: JONATHAN S JABER

MEDICARE: JONATHAN S JABER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorRT1433720326CA

General Provider Information

NPI Number : 1053246496
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN S JABER
Provider Business Mailing Address
First Line : 13181 CROSSROADS PKWY N STE 440
Second Line :
City : CITY OF INDUSTRY
State : CA
Zip : 91746-3499
Country : US
Telephone Number : 562-353-5611
Fax Number :
Provider Business Practice Location Address
First Line : 225 N MARIPOSA AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90004-4509
Country : US
Telephone Number : 213-736-5441
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2026
Last Update Date : 06/16/2026

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