Individual provider · Type 1 NPI

Jerry Chan

Addiction (Substance Use Disorder) Counselor · San Bernardino, CA

NPI number 1013796069 Active

Practice location

1369 E Highland Ave
San Bernardino, CA 92404-4640

Call (909) 571-6035 Map

Mailing address

1100 N D St
San Bernardino, CA 92410-3524

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XA020971015 (CA)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1013796069

Jerry Chan's National Provider Identifier is 1013796069, issued on Sep 27, 2023. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in San Bernardino, CA. The record was last updated on Mar 6, 2026.