Provider Demographics
NPI:1134318058
Name:LEVY, JOCELYN C (MFT)
Entity Type:Individual
Prefix:MS
First Name:JOCELYN
Middle Name:C
Last Name:LEVY
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5905 SOQUEL DR
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SOQUEL
Mailing Address - State:CA
Mailing Address - Zip Code:95073-2855
Mailing Address - Country:US
Mailing Address - Phone:831-479-3790
Mailing Address - Fax:
Practice Address - Street 1:5905 SOQUEL DR
Practice Address - Street 2:SUITE 500
Practice Address - City:SOQUEL
Practice Address - State:CA
Practice Address - Zip Code:95073-2855
Practice Address - Country:US
Practice Address - Phone:831-479-3790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 16420101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health