Provider Demographics
NPI:1508668229
Name:CARWAY, JACQUELINE ANN
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:ANN
Last Name:CARWAY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:JACKIE
Other - Middle Name:ANN
Other - Last Name:BARNETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4122 GUADALUPE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MARIPOSA
Mailing Address - State:CA
Mailing Address - Zip Code:95338-9422
Mailing Address - Country:US
Mailing Address - Phone:209-347-6497
Mailing Address - Fax:
Practice Address - Street 1:4122 GUADALUPE CREEK RD
Practice Address - Street 2:
Practice Address - City:MARIPOSA
Practice Address - State:CA
Practice Address - Zip Code:95338-9422
Practice Address - Country:US
Practice Address - Phone:209-347-6497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist