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General NPI Number Information
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NPI Number | 1184222671
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Entity Type | Organization
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Legal Business Name | HOPE SOARS BEHAVIORAL HEALTH INC.
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Dates
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Enumeration Date | 10/15/2020
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Last Update Date | 10/15/2020
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Provider Practice Location Address
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Address Line | 12127 MALL BLVD # 148
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City | VICTORVILLE
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State | CA
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Zip | 92392-7665
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Country | US
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Telephone | 442-242-1724
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Fax |
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Provider Business Mailing Address
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Address Line | 12127 MALL BLVD # 148
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City | VICTORVILLE
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State | CA
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Zip | 92392-7665
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Country | US
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Telephone | 760-220-7149
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Fax |
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Authorized Official
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Title or Position | NP/CEO
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Name | JAMESINA JOHNS
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Credential | NP
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Telephone | 760-220-7149
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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