JACOB C TANNER

MORENO VALLEY, CA
NPI1467772806
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Additional Taxonomies101YM0800X Counselor, Mental Health
Enumeration Date2010-06-08
Last Update Date2011-03-24
Business Address
-- JACOB C TANNER
13800 HEACOCK ST STE C236
MORENO VALLEY, CA 92553-3364
Phone number: 951-656-2614
Mailing Address
-- JACOB C TANNER
243 N MERIDIAN AVE SPC 71
SAN BERNARDINO, CA 92410-1317
Phone number: 909-913-3403
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