Provider Demographics
NPI:1407172919
Name:STANCIC, JOCELYNE AHO
Entity Type:Individual
Prefix:
First Name:JOCELYNE
Middle Name:AHO
Last Name:STANCIC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 E OLIVE AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-5255
Mailing Address - Country:US
Mailing Address - Phone:909-353-0035
Mailing Address - Fax:909-830-6448
Practice Address - Street 1:104 E OLIVE AVE STE 201
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-5255
Practice Address - Country:US
Practice Address - Phone:909-353-0035
Practice Address - Fax:909-830-6448
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-09
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88895106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist