Provider Demographics
NPI:1902954126
Name:JASKOLSKI, DAVID JOSEPH (MFT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:JOSEPH
Last Name:JASKOLSKI
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:MR
Other - First Name:DAVID
Other - Middle Name:JOSEPH
Other - Last Name:JASKOLSKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT
Mailing Address - Street 1:2335 COUNTRY HILLS DR
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-7319
Mailing Address - Country:US
Mailing Address - Phone:925-608-8751
Mailing Address - Fax:
Practice Address - Street 1:2335 COUNTRY HILLS DR
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-7319
Practice Address - Country:US
Practice Address - Phone:925-437-1150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36357106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist