MEDICARE: JACKELINE PAZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator
2	101YM0800X	Mental Health Counselor	ASW103611	CA
3	1041C0700X	Clinical Social Worker	LCSW113261	CA

General Provider Information

NPI Number	:	1649451691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACKELINE PAZ

Provider Business Mailing Address
First Line	:	811 S WEBSTER AVE APT 25
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92804-4133
Country	:	US
Telephone Number	:	714-351-1739
Fax Number	:

Provider Business Practice Location Address
First Line	:	811 S WEBSTER AVE APT 25
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92804-4133
Country	:	US
Telephone Number	:	714-351-1739
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2007
Last Update Date	:	02/19/2026

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Directions to “ JACKELINE PAZ ” Practice Location

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