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General NPI Number Information
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NPI Number | 1891545356
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Entity Type | Individual
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Provider Name | JORGE A FLORES
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Gender | Male
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Dates
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Enumeration Date | 03/26/2024
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 4164 BROCKTON AVE
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City | RIVERSIDE
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State | CA
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Zip | 92501-3400
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Country | US
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Telephone | 951-683-5193
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Fax | 888-588-2752
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Provider Business Mailing Address
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Address Line | 4164 BROCKTON AVE
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City | RIVERSIDE
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State | CA
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Zip | 92501-3400
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Country | US
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Telephone | 951-683-5193
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Fax | 888-588-2752
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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 | 225400000X
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Taxonomy Name | Rehabilitation 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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | MPSS-UESHNA
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License Number State | CA
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