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General NPI Number Information
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NPI Number | 1518658244
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Entity Type | Individual
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Provider Name | JESSE FLORES
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Gender | Male
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Dates
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Enumeration Date | 05/15/2023
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 3924 RIVERVIEW DR
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City | RIVERSIDE
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State | CA
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Zip | 92509-6611
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Country | US
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Telephone | 951-360-4175
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Fax |
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Provider Business Mailing Address
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Address Line | 12377 ROSWELL AVE
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City | CHINO
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State | CA
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Zip | 91710-2050
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Country | US
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Telephone | 909-974-8254
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Fax |
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 132424
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License Number State | CA
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