Provider Demographics
NPI:1548429335
Name:TRAUD, JOLENE MARIE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:JOLENE
Middle Name:MARIE
Last Name:TRAUD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 MERIDIAN AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95125-5318
Mailing Address - Country:US
Mailing Address - Phone:510-922-9757
Mailing Address - Fax:
Practice Address - Street 1:2100 BAY STATE CT
Practice Address - Street 2:
Practice Address - City:GOLD RIVER
Practice Address - State:CA
Practice Address - Zip Code:95670-8135
Practice Address - Country:US
Practice Address - Phone:925-487-7827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA90719106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist