| Doctor Name: | MS. JACQUELINE MAY LADRECH |
| NPI Number: | 1194998047 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, MFT |
| License Number: | MFC20178 |
| Business Practice Address: | 240 Tamal Vista Blvd Suite 270 Corte Madera, CA - 949251132 |
| Business Phone Number: | 4154799008 |
| Business Fax Number: | 4154990631 |
| Mailing Address: | 240 Tamal Vista Blvd, Suite 270 CORTE MADERA |
| State: | CA |
| Postal Code: | 949251132 |
| Phone Number: | 4154799008 |
| Fax Number: | 4154990631 |
| NPI Enumeration Date: | 04/10/2008 |
| NPI Last Update Date: | 04/10/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | MFC20178 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |