Healthcare Provider Details

I. General information

NPI: 1083253454
Provider Name (Legal Business Name): JACQUELYN RINALDI PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2020
Last Update Date: 08/17/2022
Certification Date: 08/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1819 CLIFF DRIVE SUITE F
SANTA BARBARA CA
93106-4589
US

IV. Provider business mailing address

9700 PORT HURON LN
LAS VEGAS NV
89134-0419
US

V. Phone/Fax

Practice location:
  • Phone: 702-610-2030
  • Fax:
Mailing address:
  • Phone: 702-610-2030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number2018-000823689
License Number StateWY
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: