Provider Demographics
NPI:1679188601
Name:SALDANA, JACQUELINE BRIANNE
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:BRIANNE
Last Name:SALDANA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22013 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-6946
Mailing Address - Country:US
Mailing Address - Phone:310-962-1995
Mailing Address - Fax:
Practice Address - Street 1:121 W WASHINGTON AVE STE 204
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94086-1101
Practice Address - Country:US
Practice Address - Phone:310-962-1995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-15
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA127624106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist