Individual
JACQUELINE IMBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
9445 FAIRWAY VIEW PL, RANCHO CUCAMONGA, CA 91730-0929
(909) 983-2020
Mailing address
9445 FAIRWAY VIEW PL, RANCHO CUCAMONGA, CA 91730-0929
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
118286
CA
172V00000X
Community Health Worker
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/10/2023
Last updated
09/26/2023
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