Individual provider · Type 1 NPI

Jackie R. Koudelka

Counselor · Stockton, CA

NPI number 1962904821 Active

Practice location

6 S El Dorado St Ste 510
Stockton, CA 95202-2804

Call (209) 623-1411 Map

Specialties and licenses

TaxonomyCodeLicense
Counselor Primary 101Y00000XNone listed

Counselor: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

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About NPI 1962904821

Jackie R. Koudelka's National Provider Identifier is 1962904821, issued on Mar 6, 2018. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in Stockton, CA. The record was last updated on Mar 6, 2018.