Jackson, Ronald Wayne

Jackson, Ronald Wayne is an sole proprietor health care provider with primary practice located at 939 N D St , San Bernardino CA 92410-3519. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Other Service Providers / Prevention Professional. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Jackson, Ronald Wayne can be contacted via phone (909) 889-6519.

Contact Information

Primary practice address
939 N D St San Bernardino CA 92410-3519
Phone: (909) 889-6519
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X R1367361019 California
Other Service Providers / Prevention Professional 405300000X RADT78265 California

Profile Details

NPI number 1922647346
LBN Legal business name Jackson, Ronald Wayne
Credentials RADT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 2nd, 2020
Last updated Feb 22nd, 2022 - about 2 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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