Individual provider · Type 1 NPI

Jacqueline Gentry

Addiction (Substance Use Disorder) Counselor · Hesperia, CA

NPI number 1780215335 Active

Practice location

11776 Mariposa Rd
Hesperia, CA 92345-1622

Call (760) 956-7542 Map

Mailing address

16065 Andover Dr
Victorville, CA 92394-1432

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 1780215335

Jacqueline Gentry's National Provider Identifier is 1780215335, issued on Feb 3, 2020. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Hesperia, CA. The record was last updated on Feb 12, 2020.