Individual
MR. JASON NILES KUKAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
954 W FOOTHILL BLVD STE A, UPLAND, CA 91786-3782
(909) 846-4222
Mailing address
41500 WASHINGTON ST APT E224, BERMUDA DUNES, CA 92203-9516
(760) 989-7608
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95023040
CA
Other
Enumeration date
10/26/2022
Last updated
10/26/2022
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