Provider Demographics
NPI:1255030755
Name:BROCATO, JOLAE (JO) (LCSW)
Entity type:Individual
Prefix:
First Name:JOLAE (JO)
Middle Name:
Last Name:BROCATO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 SAINT LOUIS AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-4560
Mailing Address - Country:US
Mailing Address - Phone:562-208-2427
Mailing Address - Fax:
Practice Address - Street 1:840 SAINT LOUIS AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-4560
Practice Address - Country:US
Practice Address - Phone:562-208-2427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW270791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical