Churchwell, Jason

Churchwell, Jason is an individual health care provider with primary practice located at 14901 Central Ave , Chino CA 91710-9500. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Forensic. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Churchwell, Jason can be contacted via phone (909) 597-1821.

Contact Information

Primary practice address
14901 Central Ave Chino CA 91710-9500
Phone: (909) 597-1821
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY23563 California
Behavioral Health & Social Service Providers / Forensic 103TF0200X

Profile Details

NPI number 1609909068
LBN Legal business name Churchwell, Jason
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2007
Last updated Jan 23rd, 2015 - about 9 years ago

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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