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General NPI Number Information
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NPI Number | 1235906975
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Entity Type | Individual
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Provider Name | JENNIFER ANGELA POCHUE
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Gender | Female
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Dates
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Enumeration Date | 12/04/2023
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Last Update Date | 12/04/2023
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Provider Practice Location Address
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Address Line | 14420 CIVIC DR STE 4
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City | VICTORVILLE
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State | CA
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Zip | 92392-2384
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Country | US
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Telephone | 760-490-0109
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Fax | 760-780-1561
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Provider Business Mailing Address
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Address Line | 6562 CALIENTE RD STE 101
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City | OAK HILLS
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State | CA
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Zip | 92344-0745
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Country | US
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Telephone | 760-490-0109
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Fax | 760-780-1561
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ASW109977
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License Number State | CA
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