Provider Demographics
NPI:1326274994
Name:ALBERNAZ, JOCELYN PAGE (COTA)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:PAGE
Last Name:ALBERNAZ
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 FORESTDALE DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:MA
Mailing Address - Zip Code:02726-4718
Mailing Address - Country:US
Mailing Address - Phone:508-567-5497
Mailing Address - Fax:
Practice Address - Street 1:636 ROCK ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-3438
Practice Address - Country:US
Practice Address - Phone:508-675-5778
Practice Address - Fax:508-675-9889
Is Sole Proprietor?:No
Enumeration Date:2009-06-09
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2095171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator