Provider Demographics
NPI:1356539852
Name:SINGER, JACQUELINE (PHD)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:SINGER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 W NAPA ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SONOMA
Mailing Address - State:CA
Mailing Address - Zip Code:95476-6408
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:710 W NAPA ST
Practice Address - Street 2:SUITE 2
Practice Address - City:SONOMA
Practice Address - State:CA
Practice Address - Zip Code:95476-6408
Practice Address - Country:US
Practice Address - Phone:707-935-6366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY8914103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic