Doctor Name: | MRS. JACQUELINE CARA PLANTE |
NPI Number: | 1043551583 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | IMF 74263 |
Business Practice Address: | 1160 S Grand Ave Glendora, CA - 917405000 |
Business Phone Number: | 6263355980 |
Business Fax Number: | |
Mailing Address: | 777 S Citrus Ave Apt 235, AZUSA |
State: | CA |
Postal Code: | 917025949 |
Phone Number: | 7144036421 |
Fax Number: | |
NPI Enumeration Date: | 03/07/2013 |
NPI Last Update Date: | 03/07/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | IMF 74263 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |