Jack Anderson
Technician, Attendant Care Provider in Victorville, CA. Individual provider (NPI-1).
NPI number1982254603
StatusActive
Last updated in NPPESSep 25, 2019
Details
- NPI
- 1982254603
- Entity type
- Individual (NPI-1)
- Name
- Jack Anderson
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 14, 2019
- Last updated
- Sep 25, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3747A0650X | Technician, Attendant Care Provider | – | – | Yes |
Practice location
14810 La Mesa RdVictorville, CA 92392-8639
Phone 760-951-0510
Mailing address
14810 La Mesa RdVictorville, CA 92392-8639
Phone 760-951-0510
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Other Attendant Care Provider providers in Victorville, CA
- Verdelle AndersonNPI 1861028540
- Marisol CuevasNPI 1336857994
- Debra GrahamNPI 1992684534
- Irene Fay LuciousNPI 1215588454
All 5 Attendant Care Provider providers in Victorville · All 3,391 providers in Victorville
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