Provider Demographics
NPI:1144378027
Name:TURNER, JAMAL PATRICK (SUBSTANCE ABUSE COUN)
Entity type:Individual
Prefix:
First Name:JAMAL
Middle Name:PATRICK
Last Name:TURNER
Suffix:
Gender:M
Credentials:SUBSTANCE ABUSE COUN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1683 SACRAMENTO DR
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348
Mailing Address - Country:US
Mailing Address - Phone:209-947-4771
Mailing Address - Fax:
Practice Address - Street 1:301 E. 13TH STREET
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95341
Practice Address - Country:US
Practice Address - Phone:209-381-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA02-009648276400000X
CA8943SUDCC101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA101Y00000XOtherCERT. A&D COUNSELOR