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NPI Code Detail

MEDICARE: JESSICA JUAREZ

MEDICARE: JESSICA JUAREZ
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
1106H00000XMarriage & Family Therapist156579CA

General Provider Information

NPI Number : 1134694797
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA JUAREZ
Provider Business Mailing Address
First Line : 1420 S MILLIKEN AVE STE 508
Second Line :
City : ONTARIO
State : CA
Zip : 91761-2337
Country : US
Telephone Number : 909-983-2020
Fax Number :
Provider Business Practice Location Address
First Line : 1420 S MILLIKEN AVE STE 508
Second Line :
City : ONTARIO
State : CA
Zip : 91761-2337
Country : US
Telephone Number : 909-983-2020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2018
Last Update Date : 03/10/2026

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Directions to “ JESSICA JUAREZ ” Practice Location

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