Provider Demographics
NPI:1558536359
Name:ARILD, JOCELYN (MA, MS,)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:
Last Name:ARILD
Suffix:
Gender:F
Credentials:MA, MS,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:896 LAKEPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKEPORT
Mailing Address - State:CA
Mailing Address - Zip Code:95453-5421
Mailing Address - Country:US
Mailing Address - Phone:707-262-1611
Mailing Address - Fax:
Practice Address - Street 1:896 LAKEPORT BLVD
Practice Address - Street 2:
Practice Address - City:LAKEPORT
Practice Address - State:CA
Practice Address - Zip Code:95453-5421
Practice Address - Country:US
Practice Address - Phone:707-262-1611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist