Provider Demographics
NPI:1922118371
Name:SHIROMOTO, JOCELYNE REGINA (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JOCELYNE
Middle Name:REGINA
Last Name:SHIROMOTO
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 E WHITING AVE
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-1931
Mailing Address - Country:US
Mailing Address - Phone:714-502-8566
Mailing Address - Fax:714-528-9676
Practice Address - Street 1:198 E WHITING AVE
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-1931
Practice Address - Country:US
Practice Address - Phone:714-502-8566
Practice Address - Fax:714-528-9676
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 124831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical