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JACLYN CORNEJO 89928 IMF
NPI 1053773960
Counselor - Mental Health in San Diego, CA

Active since March 22, 2016
3340 KEMPER ST, SUITE 105, SAN DIEGO, CA 92110(619) 523-8121(619) 523-8742 Get Directions Write a Review

NPPES record last updated: March 22, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jaclyn Cornejo 89928 Imf NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACLYN CORNEJO 89928 IMF (NPI 1053773960) is an individual mental health provider in San Diego, California, licensed in California (89928) and active in the NPI registry since March 2016.

NPPES Registry Identity

NPI1053773960
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameJACLYN CORNEJOCredential: 89928 IMF
Location Address3340 KEMPER ST, SUITE 105San Diego, CA 92110-4906
Mailing Address3340 Kemper St, Suite 105San Diego, CA 92110-4906 · (619) 523-8121 · Fax (619) 523-8742
Phone(619) 523-8121
Fax(619) 523-8742
Sole ProprietorNo
Enumeration DateMarch 22, 2016
✔ NPI 1053773960 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in CA · 89928
3340 KEMPER ST, San Diego, CA 92110
Open in Google Maps ↗

Other Identifiers 1

Medicaid373781000CA

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. BORANY TEK REINBOLD M.A.
Marriage & Family Therapist
3340 KEMPER ST, SUITE 105
SAN DIEGO, CA 92110
San Diego County (619) 523-8121
MR. MICHAEL ALLEN STEWARD BA, CAS
Counselor (Addiction (Substance Use Disorder))
3340 KEMPER ST, SUITE 105
SAN DIEGO, CA 92110
San Diego County (619) 523-8121
DR. EDWARD KELLY HOLLY D.D.S.
Dentist (General Practice)
3340 KEMPER ST, SUITE 201
SAN DIEGO, CA 92110
San Diego County (619) 224-2828
RONALD CONRAD TULIO CATC INTERN
Counselor (Addiction (Substance Use Disorder))
3340 KEMPER ST
SAN DIEGO, CA 92110
San Diego County (619) 523-8121
MS. KATE ANN PHILLIPS CADC1
Counselor (Addiction (Substance Use Disorder))
3340 KEMPER ST
SAN DIEGO, CA 92110
San Diego County (619) 523-8121
MR. KEITH ALAN PRATT
Counselor (Addiction (Substance Use Disorder))
3340 KEMPER ST, SUITE 105
SAN DIEGO, CA 92110
San Diego County (619) 523-8121
MR. MICHAEL CHRISTOPHER STILTZ RADT-1
Counselor (Addiction (Substance Use Disorder))
3340 KEMPER ST, SUITE 105
SAN DIEGO, CA 92110
San Diego County (619) 523-8121
MS. KATHERINE WEAVER KEITH LMFT
Marriage & Family Therapist
3340 KEMPER ST, #105
SAN DIEGO, CA 92110
San Diego County (619) 322-0463

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jaclyn Cornejo's NPI number?

The NPI number for Jaclyn Cornejo is 1053773960. It was assigned to this individual provider in the NPPES registry on March 22, 2016.

Where is Jaclyn Cornejo located?

Jaclyn Cornejo practices at 3340 Kemper St Suite 105, San Diego, CA 92110. The listed phone number is (619) 523-8121.

What is Jaclyn Cornejo's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Jaclyn Cornejo was last updated on March 22, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.