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NPI Code Detail

MEDICARE: JOCELYN VASQUEZ-MOTA LCSW

MEDICARE:   JOCELYN  VASQUEZ-MOTA  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor
21041C0700XClinical Social Worker110475CA

General Provider Information

NPI Number : 1205267184
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOCELYN VASQUEZ-MOTA LCSW
Provider Business Mailing Address
First Line : 823 GATEWAY CENTER WAY
Second Line :
City : SAN DIEGO
State : CA
Zip : 92102-4541
Country : US
Telephone Number : 619-515-2300
Fax Number :
Provider Business Practice Location Address
First Line : 2130 NATIONAL AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92113-2209
Country : US
Telephone Number : 619-515-2338
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2013
Last Update Date : 09/11/2023

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Directions to “ JOCELYN VASQUEZ-MOTA LCSW” Practice Location

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