Individual
JACLYN VAN DE WETERING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22672 LAMBERT ST STE 611, LAKE FOREST, CA 92630-1613
(949) 329-8161
Mailing address
1805 HUNTINGTON ST APT B, HUNTINGTON BEACH, CA 92648-3116
(714) 380-4211
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
224Z00000X
Occupational Therapy Assistant
Primary
6267
CA
Other
Enumeration date
02/17/2020
Last updated
05/01/2026
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