Healthcare Provider Details

I. General information

NPI: 1508787821
Provider Name (Legal Business Name): JEAN M. MACALINAO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 TUN JESUS CRISOSTOMO ST STE 104
TAMUNING GU
96913-3551
US

IV. Provider business mailing address

125 TUN JESUS CRISOSTOMO ST STE 104
TAMUNING GU
96913-3551
US

V. Phone/Fax

Practice location:
  • Phone: 671-649-8638
  • Fax:
Mailing address:
  • Phone: 671-649-8638
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPA-004
License Number StateGU

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: