Provider Demographics
NPI:1629454194
Name:TOLENTINO, JEAN-ARELLIA
Entity type:Individual
Prefix:DR
First Name:JEAN-ARELLIA
Middle Name:
Last Name:TOLENTINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 CALDECOTT LN UNIT 110
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-2411
Mailing Address - Country:US
Mailing Address - Phone:707-373-5473
Mailing Address - Fax:
Practice Address - Street 1:240 CALDECOTT LN UNIT 110
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-2411
Practice Address - Country:US
Practice Address - Phone:707-373-5473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-06
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34978103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical