Most Relevant Information
Provider Data
| NPI Number: | 1003221565 |
| Provider Name: | JESSICA ESTRADA RECOVERY WORKER |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/24/2014 |
| Last Updated: | 06/24/2014 |
Provider Practice Location
2275 E COOLEY DR
COLTON
CA
923246324
Practice Location Phone/Fax
| Phone: | 9093701777 |
| Fax: | 9093701776 |
Provider Mailing Location
2275 EAST COOLEY DRIVE
COLTON
CA
92324
Provider Mailing Phone/Fax
| Phone: | 9093701777 |
| Fax: | 9093701776 |