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NPI Code Detail

MEDICARE: JESUS S MARIN

MEDICARE: JESUS S MARIN
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) CounselorRT1422271025CA

General Provider Information

NPI Number : 1750257945
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESUS S MARIN
Provider Business Mailing Address
First Line : 16241 CERES AVE
Second Line :
City : FONTANA
State : CA
Zip : 92335-4505
Country : US
Telephone Number : 909-688-7338
Fax Number :
Provider Business Practice Location Address
First Line : 650 S INDIAN HILL BLVD
Second Line :
City : CLAREMONT
State : CA
Zip : 91711-5444
Country : US
Telephone Number : 909-688-1338
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2025
Last Update Date : 04/13/2026

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Directions to “ JESUS S MARIN ” Practice Location

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