Provider Demographics
NPI:1487883864
Name:MISHLER, JAMIE L (PSYD)
Entity type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:L
Last Name:MISHLER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:MS
Other - First Name:JAMIE
Other - Middle Name:LEWIS
Other - Last Name:DUTTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3403 10TH ST
Mailing Address - Street 2:STE 605
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92501
Mailing Address - Country:US
Mailing Address - Phone:909-201-7786
Mailing Address - Fax:661-868-6666
Practice Address - Street 1:BEHAVIORAL HEALTH CONSULTANTS
Practice Address - Street 2:15434 SAGE ST
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92392
Practice Address - Country:US
Practice Address - Phone:760-843-0506
Practice Address - Fax:661-868-6666
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-07
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY26435103TF0200X, 103TC0700X
103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)