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Individual

ADRIAN JACOB CARRASCO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1738 N WATERMAN AVE STE 1, SAN BERNARDINO, CA 92404-5131
(909) 693-3302
Mailing address
1076 SANTO ANTONIO DR STE B, COLTON, CA 92324-8183
(909) 433-9824
(909) 433-9830

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
2110806-I
CA
101YA0400X
Addiction (Substance Use Disorder) Counselor
171M00000X
Case Manager/Care Coordinator
CA
172V00000X
Community Health Worker
CA
175T00000X
Peer Specialist
373H00000X
Day Training/Habilitation Specialist
Primary
CA

Other

Enumeration date
01/23/2018
Last updated
05/09/2025
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