JACQUELINE MICHAEL WILDE LMFT NPI 1386334217

NPI Information

  • NPI: 1386334217
  • Provider Name: JACQUELINE MICHAEL WILDE, LMFT
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • Address: 2107 SIESTA LN
    SANTA ROSA, CA
    ZIP 95404
  • Phone: (707) 331-9658

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NPI Details

Jacqueline Michael Wilde, LMFT is a mental health counselor in Santa Rosa, CA. Jacqueline Michael Wilde, LMFT NPI is 1386334217. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2107 SIESTA LN
SANTA ROSA, CA
ZIP 95404-238
Phone: (707) 331-9658

The enumeration date for this NPI number is 5/12/2023 and was last updated on 5/12/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental Health46715CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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