Provider Demographics
NPI:1518141118
Name:ORMEROD, JACQUELINE (BA, BA HONORS)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:ORMEROD
Suffix:
Gender:F
Credentials:BA, BA HONORS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18837 BROOKHURST ST STE 110
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-7301
Mailing Address - Country:US
Mailing Address - Phone:714-536-0077
Mailing Address - Fax:714-428-3105
Practice Address - Street 1:18837 BROOKHURST ST STE 110
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-7301
Practice Address - Country:US
Practice Address - Phone:714-536-0077
Practice Address - Fax:714-428-3105
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2022-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health