Provider Demographics
NPI:1386949519
Name:MASON, JASON JAMES
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:JAMES
Last Name:MASON
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 1:4630 W JACQUELYN AVE STE 116
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-6431
Mailing Address - Country:US
Mailing Address - Phone:559-275-2324
Mailing Address - Fax:559-275-2329
Practice Address - Street 1:4630 W JACQUELYN AVE STE 116
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93722-6431
Practice Address - Country:US
Practice Address - Phone:559-275-2324
Practice Address - Fax:559-275-2329
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty