Provider Demographics
NPI:1700602901
Name:ABDOLCADER, JAYNAP
Entity type:Individual
Prefix:
First Name:JAYNAP
Middle Name:
Last Name:ABDOLCADER
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:PO BOX 14
Mailing Address - Street 2:
Mailing Address - City:BYRON
Mailing Address - State:CA
Mailing Address - Zip Code:94514-0014
Mailing Address - Country:US
Mailing Address - Phone:415-374-1491
Mailing Address - Fax:
Practice Address - Street 1:1181 CENTRAL BLVD STE D
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-2252
Practice Address - Country:US
Practice Address - Phone:415-374-1491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT150880106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist