Individual provider · Type 1 NPI

Jack Porter

Addiction (Substance Use Disorder) Counselor · Fresno, CA

NPI number 1780734574 Active

Practice location

3707 E Shields Ave
Fresno, CA 93726-7029

Call (559) 229-9040 Map

Fax (559) 229-9060

Mailing address

970 Makenna St
Lemoore, CA 93245-4502

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 1780734574

Jack Porter's National Provider Identifier is 1780734574, issued on Jan 12, 2007. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Fresno, CA. The record was last updated on Jul 8, 2007.