| Jacquelyn Irene Mitchell, MFTI | |
| 
					3049 Darlene Ln, Modesto, CA 95355-4157  | |
| (209) 535-1997 | |
| Not Available | 
| Full Name | Jacquelyn Irene Mitchell | 
|---|---|
| Gender | Female | 
| Speciality | Marriage & Family Therapist | 
| Location | 3049 Darlene Ln, Modesto, California | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1750620902 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | IMF 56335 (California) | Primary | 
| Entity Name | County Of Amador | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1205055886 PECOS PAC ID: 9537223375 Enrollment ID: O20140225001385  | 
| Entity Name | Sud Specialty Group - Ca | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1972138238 PECOS PAC ID: 9537534177 Enrollment ID: O20230412001370  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Jacquelyn Irene Mitchell, MFTI 3049 Darlene Ln, Modesto, CA 95355-4157 Ph: (209) 535-1997  | Jacquelyn Irene Mitchell, MFTI 3049 Darlene Ln, Modesto, CA 95355-4157 Ph: (209) 535-1997  | 
Roberta Margaret Elledge, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 819 15th St, Modesto, CA 95354 Phone: 209-549-9608 Fax: 209-522-5700  | |
Paige A Cole,  Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 121 Downey Ave, Modesto, CA 95354 Phone: 559-577-6995  | |
Ana Lisette Santos, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 1400 K St Ste B, Modesto, CA 95354 Phone: 209-550-5869 Fax: 209-523-0442  | |
Mr. Pete Herron, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 615 13th St, Modesto, CA 95354 Phone: 209-380-3187 Fax: 209-846-0913  | |
Emily Jane Mitchell, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 500 N 9th St Ste C, Modesto, CA 95350 Phone: 209-552-2720  | |
Mrs. Pamela Christine Remides, MFT TRAINEE Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 615 14th St, Modesto, CA 95354 Phone: 209-524-4858  | |
Elisa Aileen Gonzalez,  Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 5815 Stoddard Rd Ste 600, Modesto, CA 95356 Phone: 209-348-9786  |