Provider Demographics
NPI:1134843857
Name:ALEIADIH, JOCELYN MARIE (LCSW)
Entity type:Individual
Prefix:MS
First Name:JOCELYN
Middle Name:MARIE
Last Name:ALEIADIH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JOCELYN
Other - Middle Name:MARIE
Other - Last Name:FARRAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:3769 TIBBETTS ST STE A
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-2638
Mailing Address - Country:US
Mailing Address - Phone:951-405-8131
Mailing Address - Fax:
Practice Address - Street 1:3769 TIBBETTS ST STE A
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2638
Practice Address - Country:US
Practice Address - Phone:951-405-8131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-27
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW1204071041C0700X
COCSW.099287521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical