Demont Jefferson

NPI 1841083300 · on the registry since 2025

Practice

Address: 696 S Tippecanoe Ave
San Bernardino, CA 92408
Phone: (909) 723-1695
Organisation at this address: Young Visionaries Youth Leadership Academy
Community Action Partnership Of San Bernardino County
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 9

Registry record

Primary taxonomy: 172V00000X
172V00000X
Licence states on file: CA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2025-05-27

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California