Butler, Jacqueline
Butler, Jacqueline is an sole proprietor health care provider with primary practice located at 4700 Spring St Suite 204, La Mesa CA 91941-5263. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Butler, Jacqueline can be contacted via phone (619) 644-5750.Contact Information
Primary practice address
4700 Spring St Suite 204
La Mesa CA 91941-5263
Phone: (619) 644-5750
Fax: (619) 644-5751
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | P1690 | Tennessee |
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | PSY19513 | California |
Profile Details
| NPI number | 1023120177 |
|---|---|
| LBN Legal business name | Butler, Jacqueline |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 31st, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023120177 | NPPES |
| California | Other | 4385231 | AETNA INSURANCE |
| California | MEDICAID | 8718236 | AETNA INSURANCE |
| California | Other | 4106863 | AETNA INSURANCE |
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