Gonzalez, Jackeline Guzman

Gonzalez, Jackeline Guzman is an individual health care provider with primary practice located at 790 Via Lata Ste 300 , Colton CA 92324-3978. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Marriage & Family Therapist, Other Service Providers / Case Manager/Care Coordinator. Behavioral Health & Social Service Providers / Marriage & Family Therapist is her primary health care specialty. Gonzalez, Jackeline Guzman can be contacted via phone (909) 433-0445.

Contact Information

Primary practice address
790 Via Lata Ste 300 Colton CA 92324-3978
Phone: (909) 433-0445
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X AMFT117538 California
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1225434392
LBN Legal business name Gonzalez, Jackeline Guzman
Credentials AMFT
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 17th, 2014
Last updated Feb 12th, 2020 - about 5 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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Identifiers

StateTypeNumberIssuer
All States NPI 1225434392 NPPES
California Other AMFT117538 BOARD OF BEHAVIORAL SCIENCES

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