Organization
CDCR/CIM
Active
Organization
CDCR/CIM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR STEVEN JORDAN PH.D. (CHIEF OF MENTAL HEALTH)
(909) 606-7159
Entity
Organization
Contact information
Practice address
14901 CENTRAL AVE, CHINO, CA 91710-9500
(909) 606-7159
(909) 606-7044
Mailing address
14901 CENTRAL AVE, CHINO, CA 91710-9500
(909) 606-7159
(909) 606-7044
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
PSY13916
CA
Other
Enumeration date
07/22/2014
Last updated
07/22/2014
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