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Individual
MR. JEFFERY PONCE
Active
Individual
MR. JEFFERY PONCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
P0412282013
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CO53190518
CCAPP
CA
01
—
P0412282013
BREINING INSTITUTE
CA
Enumeration date
10/12/2007
Last updated
12/31/2024
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