Individual
JACKELYN BROVDWIACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20 CENTERPOINTE DR STE 130, LA PALMA, CA 90623-2562
(657) 325-8313
Mailing address
20 CENTERPOINTE DR STE 130, LA PALMA, CA 90623-2562
(657) 325-8313
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
106S00000X
Behavior Technician
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
CA
Other
Enumeration date
12/03/2021
Last updated
04/30/2026
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