Provider Demographics
NPI:1982310132
Name:NEAL, JIBRI JABARI
Entity Type:Individual
Prefix:
First Name:JIBRI
Middle Name:JABARI
Last Name:NEAL
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 1:49713 GORMAN POST RD
Mailing Address - Street 2:
Mailing Address - City:GORMAN
Mailing Address - State:CA
Mailing Address - Zip Code:93243-9701
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:49713 GORMAN POST RD
Practice Address - Street 2:
Practice Address - City:GORMAN
Practice Address - State:CA
Practice Address - Zip Code:93243-9701
Practice Address - Country:US
Practice Address - Phone:661-724-0001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-30
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)