Provider Demographics
NPI:1639781321
Name:SCHURKMAN, JARED ERIC
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:ERIC
Last Name:SCHURKMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 HIGHPOINTE DR APT 208
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-5960
Mailing Address - Country:US
Mailing Address - Phone:951-751-4391
Mailing Address - Fax:951-817-5604
Practice Address - Street 1:255 E RINCON ST
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-1367
Practice Address - Country:US
Practice Address - Phone:951-817-5328
Practice Address - Fax:951-817-5604
Is Sole Proprietor?:No
Enumeration Date:2020-08-23
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst