Provider Demographics
NPI:1508660929
Name:ATOIGUE, JACLYNE DARLENE (MSW, ASW)
Entity type:Individual
Prefix:
First Name:JACLYNE
Middle Name:DARLENE
Last Name:ATOIGUE
Suffix:
Gender:
Credentials:MSW, ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1329 139TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-2620
Mailing Address - Country:US
Mailing Address - Phone:510-816-1130
Mailing Address - Fax:
Practice Address - Street 1:5515 DOYLE ST STE 1
Practice Address - Street 2:
Practice Address - City:EMERYVILLE
Practice Address - State:CA
Practice Address - Zip Code:94608-2510
Practice Address - Country:US
Practice Address - Phone:510-243-9460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical