Healthcare Provider Details

I. General information

NPI: 1972096311
Provider Name (Legal Business Name): JACQUELYN PAZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2018
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15600 CONCORD CIR
MORGAN HILL CA
95037-7110
US

IV. Provider business mailing address

18 MORERA LN
MORGAN HILL CA
95037-7180
US

V. Phone/Fax

Practice location:
  • Phone: 408-201-6000
  • Fax:
Mailing address:
  • Phone: 408-713-8754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number142264
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: