Provider Demographics
NPI:1881847143
Name:KABELAC, JAYME MARIE
Entity Type:Individual
Prefix:
First Name:JAYME
Middle Name:MARIE
Last Name:KABELAC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JAYME
Other - Middle Name:MARIE
Other - Last Name:DESTEFANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:930 EASY ST
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-6215
Mailing Address - Country:US
Mailing Address - Phone:408-910-4109
Mailing Address - Fax:
Practice Address - Street 1:17760 MONTEREY RD STE A4
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-7305
Practice Address - Country:US
Practice Address - Phone:408-659-6025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-30
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW749721041C0700X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical