Provider Demographics
NPI:1376729749
Name:MCWALTER MOHAN, JAQUELINE (LMFT)
Entity Type:Individual
Prefix:
First Name:JAQUELINE
Middle Name:
Last Name:MCWALTER MOHAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:JACQUELINE
Other - Middle Name:
Other - Last Name:DAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5957 S MOONEY BLVD
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-9394
Mailing Address - Country:US
Mailing Address - Phone:559-737-4669
Mailing Address - Fax:
Practice Address - Street 1:1055 W HENDERSON AVE
Practice Address - Street 2:
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257-1490
Practice Address - Country:US
Practice Address - Phone:559-788-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-16
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist