Provider Demographics
NPI:1518612555
Name:JACQUET-JAMES, BRIANA (LCSW)
Entity Type:Individual
Prefix:
First Name:BRIANA
Middle Name:
Last Name:JACQUET-JAMES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:BRIE
Other - Middle Name:
Other - Last Name:JACQUET
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:2871 DALHART AVE
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-1913
Mailing Address - Country:US
Mailing Address - Phone:818-428-9645
Mailing Address - Fax:
Practice Address - Street 1:5655 LINDERO CANYON RD STE 425
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-4046
Practice Address - Country:US
Practice Address - Phone:805-365-4747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-17
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW1047371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical