Individual
CANDACE JIMENEZ-LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
316 E E ST, ONTARIO, CA 91764-3712
(909) 983-4466
Mailing address
11556 BARRETT DR, RANCHO CUCAMONGA, CA 91730-7249
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
CA
172V00000X
Community Health Worker
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
08/15/2018
Last updated
05/28/2025
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