Provider Demographics
NPI:1417782434
Name:MCBRIDE, JAMILYN (MSW BHPP)
Entity type:Individual
Prefix:
First Name:JAMILYN
Middle Name:
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:MSW BHPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 W DANA DR
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85143-5410
Mailing Address - Country:US
Mailing Address - Phone:480-238-6842
Mailing Address - Fax:
Practice Address - Street 1:36275 N GANTZEL RD STE 102
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85140-7320
Practice Address - Country:US
Practice Address - Phone:480-590-7147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)