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Individual
MR. INDIANA JASON WOMACK
Active
Individual
MR. INDIANA JASON WOMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.A., CMPSS
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
MPSS-CYUFDS
CA
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
06/17/2022
Last updated
08/12/2025
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