Basic Information
| Provider Information | |||||||||
| NPI: | 1831621218 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STRINGER | ||||||||
| FirstName: | JASON | ||||||||
| MiddleName: | GABRIEL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 233 BASELINE RD | ||||||||
| Address2: | |||||||||
| City: | LA VERNE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917502353 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9098332986 | ||||||||
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| Practice Location | |||||||||
| Address1: | 233 BASELINE RD | ||||||||
| Address2: | |||||||||
| City: | LA VERNE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917502353 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9098332986 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2017 | ||||||||
| LastUpdateDate: | 09/04/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 10393-R | CA | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 106H00000X | 114608 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.