Amezcua, Juan Manuel

Amezcua, Juan Manuel is an sole proprietor health care provider with primary practice located at 16940 Highway 14 , Mojave CA 93501-1238. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Other Service Providers / Case Manager/Care Coordinator, Student, Health Care / Student in an Organized Health Care Education/Training Program. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Amezcua, Juan Manuel can be contacted via phone (661) 824-5020.

Contact Information

Primary practice address
16940 Highway 14 Mojave CA 93501-1238
Phone: (661) 824-5020
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1285387258
LBN Legal business name Amezcua, Juan Manuel
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 31st, 2022
Last updated Mar 19th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285387258 NPPES
California Other 95-2633765 MEDI-CAL

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