Provider Demographics
NPI:1508174913
Name:MALONEY, JAMI ALLISON (MSW, ASW)
Entity Type:Individual
Prefix:MRS
First Name:JAMI
Middle Name:ALLISON
Last Name:MALONEY
Suffix:
Gender:F
Credentials:MSW, ASW
Other - Prefix:MS
Other - First Name:JAMI
Other - Middle Name:ALLISON
Other - Last Name:EKSTROM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, ASW
Mailing Address - Street 1:1400 N NORMA ST
Mailing Address - Street 2:
Mailing Address - City:RIDGECREST
Mailing Address - State:CA
Mailing Address - Zip Code:93555-2575
Mailing Address - Country:US
Mailing Address - Phone:760-499-7406
Mailing Address - Fax:760-499-9259
Practice Address - Street 1:1400 N NORMA ST
Practice Address - Street 2:
Practice Address - City:RIDGECREST
Practice Address - State:CA
Practice Address - Zip Code:93555-2575
Practice Address - Country:US
Practice Address - Phone:760-499-7406
Practice Address - Fax:760-499-9259
Is Sole Proprietor?:No
Enumeration Date:2010-09-20
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CAASW297371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)