Provider Demographics
NPI:1235336215
Name:DORADEA, JAIME ANTONIO (LCSW)
Entity type:Individual
Prefix:MR
First Name:JAIME
Middle Name:ANTONIO
Last Name:DORADEA
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5222 PIRRONE CT STE 101A
Mailing Address - Street 2:
Mailing Address - City:SALIDA
Mailing Address - State:CA
Mailing Address - Zip Code:95368-9072
Mailing Address - Country:US
Mailing Address - Phone:925-282-1778
Mailing Address - Fax:415-296-5299
Practice Address - Street 1:5222 PIRRONE CT STE 101A
Practice Address - Street 2:
Practice Address - City:SALIDA
Practice Address - State:CA
Practice Address - Zip Code:95368-9072
Practice Address - Country:US
Practice Address - Phone:925-282-1778
Practice Address - Fax:415-296-5299
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAACSW73503101YM0800X
CA936631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health