Individual provider · Type 1 NPI

Jacqueline R. Fuller

Addiction (Substance Use Disorder) Counselor · Pomona, CA

NPI number 1285928523 Active

Practice location

160 E Holt Ave
Pomona, CA 91767-5406

Call (909) 620-2521 Map

Mailing address

313 S Cataract Ave
San Dimas, CA 91773-3015

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

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

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About NPI 1285928523

Jacqueline R. Fuller's National Provider Identifier is 1285928523, issued on Jun 3, 2011. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Pomona, CA. The record was last updated on Jun 3, 2011.