Provider Demographics
NPI:1922831189
Name:CURTIS, JACKELINNE
Entity type:Individual
Prefix:MRS
First Name:JACKELINNE
Middle Name:
Last Name:CURTIS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JACKELINNE
Other - Middle Name:
Other - Last Name:MUNOZ LUNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14446 VICTORIA ESTATES LN
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-2964
Mailing Address - Country:US
Mailing Address - Phone:619-219-9375
Mailing Address - Fax:
Practice Address - Street 1:221 W CREST ST
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-1739
Practice Address - Country:US
Practice Address - Phone:760-744-3672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)