Individual
JASON REMBOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1330 W RAMSEY ST, BANNING, CA 92220-4477
(760) 773-6898
Mailing address
1330 W RAMSEY ST, BANNING, CA 92220-4477
(760) 773-6898
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
R1463270322
CA
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
04/07/2022
Last updated
01/23/2024
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