Healthcare Provider Details

I. General information

NPI: 1467701722
Provider Name (Legal Business Name): JAIME WARD PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2012
Last Update Date: 12/09/2022
Certification Date: 12/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 QUEBEC AVE
CORCORAN CA
93212-9715
US

IV. Provider business mailing address

PO BOX 3
GOSHEN CA
93227-0003
US

V. Phone/Fax

Practice location:
  • Phone: 559-992-7100
  • Fax:
Mailing address:
  • Phone: 925-998-9383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY31321
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: