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General NPI Number Information
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NPI Number | 1720698707
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Entity Type | Individual
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Provider Name | ADAM MICHAEL JAURIGUI LCSW
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Gender | Male
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Dates
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Enumeration Date | 08/05/2020
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Last Update Date | 08/05/2020
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Provider Practice Location Address
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Address Line | 10601 CHURCH ST STE 124
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-6840
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Country | US
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Telephone | 626-755-7041
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Fax |
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Provider Business Mailing Address
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Address Line | 7308 GREENHAVEN AVE APT 1
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-6397
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Country | US
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Telephone | 626-755-7041
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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