Provider Demographics
NPI:1356734073
Name:JAWOR, VERONICA (RASI)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:JAWOR
Suffix:
Gender:F
Credentials:RASI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 LANDING CIR STE 1
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-7901
Mailing Address - Country:US
Mailing Address - Phone:530-893-3698
Mailing Address - Fax:
Practice Address - Street 1:40 LANDING CIR
Practice Address - Street 2:SUITE 1
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-7901
Practice Address - Country:US
Practice Address - Phone:530-893-3698
Practice Address - Fax:530-893-3748
Is Sole Proprietor?:No
Enumeration Date:2015-03-05
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARI-J1402061825101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)