Provider Demographics
NPI:1649069881
Name:DE ANDA, JOCELYN (CD, CLC)
Entity type:Individual
Prefix:
First Name:JOCELYN
Middle Name:
Last Name:DE ANDA
Suffix:
Gender:
Credentials:CD, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 S CAESAR RODNEY AVE
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:DE
Mailing Address - Zip Code:19934-1111
Mailing Address - Country:US
Mailing Address - Phone:505-280-7809
Mailing Address - Fax:
Practice Address - Street 1:640 S STATE ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-3530
Practice Address - Country:US
Practice Address - Phone:302-674-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174N00000XOther Service ProvidersLactation Consultant, Non-RN