Individual
DR. JACQUELINE BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
4700 SPRING ST, SUITE 204, LA MESA, CA 91941-5263
(619) 644-5750
(619) 644-5751
Mailing address
4180 MARIAN ST, LA MESA, CA 91941-7426
(619) 644-5750
(619) 644-5751
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
P1690
TN
103T00000X
Psychologist
Primary
PSY19513
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4106863
BLUE CROSS OF TN
TN
01
—
4385231
AETNA INSURANCE
CA
05
—
8718236
—
CA
Enumeration date
08/31/2006
Last updated
07/08/2007
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