Healthcare Provider Details

I. General information

NPI: 1679984348
Provider Name (Legal Business Name): JOHN ANDREW RINCON JR. AOD COUNSELOR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JOHN A RINCON JR. AOD COUNSELOR

II. Dates (important events)

Enumeration Date: 05/15/2014
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3430 COGSWELL RD
EL MONTE CA
91732-2785
US

IV. Provider business mailing address

23950 PRADO LN
COLTON CA
92324-9734
US

V. Phone/Fax

Practice location:
  • Phone: 626-453-3406
  • Fax:
Mailing address:
  • Phone: 909-514-1958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number10436
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: