Organization
JBL MENTAL HEALTH NURSING CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON BRETT LARICK PMHNP (NURSE PRACTITIONER)
(626) 963-4467
Entity
Organization
Contact information
Practice address
415 W ROUTE 66 STE 202, GLENDORA, CA 91740-4335
(626) 963-4467
Mailing address
415 W ROUTE 66 STE 202, GLENDORA, CA 91740-4335
(626) 963-4467
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/01/2024
Last updated
11/01/2024
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