MEDICARE: JOCELYNE ISABELLE GAYTAN

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	103TF0000X	Family Psychologist
2	104100000X	Social Worker
3	1041C0700X	Clinical Social Worker
4	1041S0200X	School Social Worker
5	101Y00000X	Counselor

General Provider Information

NPI Number	:	1861176125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOCELYNE ISABELLE GAYTAN

Provider Business Mailing Address
First Line	:	40 NORTH ST
Second Line	:
City	:	WAPATO
State	:	WA
Zip	:	98951-9738
Country	:	US
Telephone Number	:	509-731-9548
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 NORTH ST
Second Line	:
City	:	WAPATO
State	:	WA
Zip	:	98951-9738
Country	:	US
Telephone Number	:	509-731-9548
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2023
Last Update Date	:	02/12/2024

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