Provider Demographics
NPI:1457669327
Name:TURNER, JACLYN (MA)
Entity Type:Individual
Prefix:MS
First Name:JACLYN
Middle Name:
Last Name:TURNER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MISS
Other - First Name:JACLYN
Other - Middle Name:
Other - Last Name:JARRARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:454 S CENTER ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866-2702
Mailing Address - Country:US
Mailing Address - Phone:714-321-7074
Mailing Address - Fax:
Practice Address - Street 1:454 S CENTER ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-2702
Practice Address - Country:US
Practice Address - Phone:714-321-7074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC48945106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist