=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013136167
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JUAN M PINON SUBSTANCE ABUSE COUN
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/25/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1010 S UNION AVE
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93307-3642
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-321-0234
-----------------------------------------------------
Fax | 661-321-9856
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 418 HAZEL ST
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93307-2520
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-322-3821
-----------------------------------------------------
Fax | 661-321-9856
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number | P0412010953
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------