Provider Demographics
NPI:1063990554
Name:CADDEL, JINXI (PSYD)
Entity type:Individual
Prefix:DR
First Name:JINXI
Middle Name:
Last Name:CADDEL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3425 POTTER ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-4268
Mailing Address - Country:US
Mailing Address - Phone:541-329-9470
Mailing Address - Fax:
Practice Address - Street 1:200 E 11TH AVE STE 260
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3200
Practice Address - Country:US
Practice Address - Phone:541-329-9470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-06
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health