Provider Demographics
NPI:1205914454
Name:MILLSTEIN, JAYNE (BS CHILD DEVELOPMENT)
Entity type:Individual
Prefix:MS
First Name:JAYNE
Middle Name:
Last Name:MILLSTEIN
Suffix:
Gender:F
Credentials:BS CHILD DEVELOPMENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2818 LA SALLE AVE
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-5702
Mailing Address - Country:US
Mailing Address - Phone:714-680-9032
Mailing Address - Fax:714-680-8207
Practice Address - Street 1:801 E CHAPMAN AVE
Practice Address - Street 2:#230
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831-3839
Practice Address - Country:US
Practice Address - Phone:714-680-9032
Practice Address - Fax:714-680-8207
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator