Individual
JEREMIAH J KROEKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BC-PMHNP
Contact information
Practice address
15434 W SAGE ST, VICTORVILLE, CA 92392-9751
(760) 843-0506
Mailing address
522 SAN JACINTO ST, REDLANDS, CA 92373-5751
(909) 553-5776
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95022927
CA
Other
Enumeration date
11/29/2022
Last updated
06/10/2023
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