Provider Demographics
NPI:1033445721
Name:SAENZ, JACQUELINE J (LCSW)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:J
Last Name:SAENZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22638 FIGUEROA ST APT 4
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90745-4419
Mailing Address - Country:US
Mailing Address - Phone:310-292-2549
Mailing Address - Fax:
Practice Address - Street 1:22638 FIGUEROA ST APT 4
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745-4419
Practice Address - Country:US
Practice Address - Phone:310-292-2549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-30
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA286901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical