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General NPI Number Information
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NPI Number | 1477785871
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Entity Type | Individual
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Provider Name | JACLYN SCHWARTZ
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Gender | Female
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Dates
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Enumeration Date | 08/18/2009
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Last Update Date | 07/09/2019
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Provider Practice Location Address
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Address Line | 1582 W SAN MARCOS BLVD STE 105
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City | SAN MARCOS
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State | CA
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Zip | 92078
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Country | US
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Telephone | 858-367-0876
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Fax |
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Provider Business Mailing Address
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Address Line | 2585 VISTA LAGO TER
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City | ESCONDIDO
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State | CA
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Zip | 92029-5407
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Country | US
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Telephone | 104-993-8033
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 92804
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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