Individual
JACQUELINE ALEJANDRA BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
14344 CAJON AVE STE 102, VICTORVILLE, CA 92392-4301
(760) 243-3999
Mailing address
14344 CAJON AVE STE 102, VICTORVILLE, CA 92392-4301
(760) 243-3999
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
112865
CA
1041C0700X
Clinical Social Worker
ASW112865
CA
Other
Enumeration date
10/07/2022
Last updated
11/22/2024
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