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NPI Code Detail

MEDICARE: JAMES EDWARD CURTIS IV ACSW

MEDICARE: JAMES EDWARD CURTIS IV ACSW
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
1171M00000XCase Manager/Care Coordinator
2104100000XSocial Worker118002CA

General Provider Information

NPI Number : 1790132108
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES EDWARD CURTIS IV ACSW
Provider Business Mailing Address
First Line : 7349 MILLIKEN AVE
Second Line : 140-269
City : RANCHO CUCAMONGA
State : CA
Zip : 91730-7435
Country : US
Telephone Number : 909-217-8602
Fax Number :
Provider Business Practice Location Address
First Line : 850 E FOOTHILL BLVD
Second Line :
City : RIALTO
State : CA
Zip : 92376-5230
Country : US
Telephone Number : 909-421-4690
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2016
Last Update Date : 09/18/2023

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