MEDICARE: JORGE ALBERTO CERVANTES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor		CA

General Provider Information

NPI Number	:	1134059090
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORGE ALBERTO CERVANTES

Provider Business Mailing Address
First Line	:	231 E ALESSANDRO BLVD STE A301
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92508-5084
Country	:	US
Telephone Number	:	951-201-1908
Fax Number	:

Provider Business Practice Location Address
First Line	:	3020 MANCHESTER CIR
Second Line	:
City	:	CORONA
State	:	CA
Zip	:	92879-6127
Country	:	US
Telephone Number	:	951-201-1908
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2026
Last Update Date	:	05/21/2026

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Directions to “ JORGE ALBERTO CERVANTES ” Practice Location

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