Healthcare Provider Details

I. General information

NPI: 1265346019
Provider Name (Legal Business Name): JJKI MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 GREEN RIVER RD STE 108
CORONA CA
92878
US

IV. Provider business mailing address

4300 GREEN RIVER RD STE 108
CORONA CA
92878
US

V. Phone/Fax

Practice location:
  • Phone: 909-367-6818
  • Fax:
Mailing address:
  • Phone: 909-367-6818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: JAMIL MOHD SYED
Title or Position: CEO
Credential:
Phone: 909-367-6818