Provider Demographics
NPI:1063990539
Name:DEILGAT, JENELLE ANGELINA (MA)
Entity type:Individual
Prefix:
First Name:JENELLE
Middle Name:ANGELINA
Last Name:DEILGAT
Suffix:
Gender:
Credentials:MA
Other - Prefix:
Other - First Name:JENELLE
Other - Middle Name:ANGELINA
Other - Last Name:GREIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 21354
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92021-0989
Mailing Address - Country:US
Mailing Address - Phone:619-722-0511
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 21354
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-0989
Practice Address - Country:US
Practice Address - Phone:619-722-0511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-06
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95613106H00000X
CA3379101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95613OtherAMFT
CA3379OtherAPCC