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Jaqueline Alexis Gorodetsky
Psychiatric/Mental Health Nurse Practitioner in Oak Park, California
NPI 1619730660

Jaqueline Alexis Gorodetsky is a Psychiatric/Mental Health Nurse Practitioner based in Oak Park, CA and is specialized in Psychiatric/Mental Health. Jaqueline Alexis Gorodetsky practices in Oak Park, CA. The NPI Number for Jaqueline Alexis Gorodetsky is 1619730660 and holds a License No. 95027727 (California).

The current practice location address for Jaqueline Alexis Gorodetsky is 499 Pesaro St, Oak Park, CA and can be reached out via phone at 323-842-6860.

Location: 499 Pesaro St, Oak Park, CA, 91377-4838
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1619730660
Provider Name
Jaqueline Alexis Gorodetsky
Credential
Provider Entity Type
Individual
Gender
Female
Address
499 Pesaro St, Oak Park, CA, 91377-4838
Phone Number
323-842-6860
Fax Number
Provider Enumeration Date
02/02/2024
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
499 Pesaro St
City
Oak Park
State
California
Zip
91377-4838
Phone Number
323-842-6860
Fax Number
person
Provider Business Mailing Address Details
Address
499 Pesaro St
City
Oak Park
State
California
Zip
91377-4838
Phone Number
323-842-6860
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
363LP0808X
License No.
95027727 (California)
Definition
Definition to come...
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