Provider Demographics
NPI:1639264039
Name:JAMES, JAYMEE LYN (MFTINTERN)
Entity Type:Individual
Prefix:
First Name:JAYMEE
Middle Name:LYN
Last Name:JAMES
Suffix:
Gender:F
Credentials:MFTINTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1145 N CALIFORNIA ST
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95202-1537
Mailing Address - Country:US
Mailing Address - Phone:209-644-5054
Mailing Address - Fax:
Practice Address - Street 1:1145 N CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95202-1537
Practice Address - Country:US
Practice Address - Phone:209-644-5054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA81836106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist