Jacqueline Joyce Mayes-Pehl

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Needles, CA

NPI 1407046212 · NPPES record last updated Jul 27, 2007

Key facts

NPI
1407046212
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
300 H St
Needles, CA 92363-2928
Phone
(760) 326-4590
Fax
(760) 326-3154
NPI assigned
Jul 27, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Yes

Addresses

Primary practice location

300 H St
Needles, CA 92363-2928

Mailing address

300 H St
Needles, CA 92363-2928
Phone (760) 326-4590

Other providers in Needles, CA

All providers in Needles, CA · Addiction (Substance Use Disorder) Counselor in California

Sources for this page

Verify at the official NPI Registry.