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NPI Code Detail

MEDICARE: MR. JOHN ANDREW RINCON JR. AOD COUNSELOR

MEDICARE: MR. JOHN ANDREW RINCON JR. AOD COUNSELOR
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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YA0400XAddiction (Substance Use Disorder) Counselor10436CA

General Provider Information

NPI Number : 1679984348
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN ANDREW RINCON JR. AOD COUNSELOR
Provider Business Mailing Address
First Line : 23950 PRADO LN
Second Line :
City : COLTON
State : CA
Zip : 92324-9734
Country : US
Telephone Number : 909-514-1958
Fax Number :
Provider Business Practice Location Address
First Line : 3430 COGSWELL RD
Second Line :
City : EL MONTE
State : CA
Zip : 91732-2785
Country : US
Telephone Number : 626-453-3406
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2014
Last Update Date : 07/11/2023

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