JACQUELINE MICHAEL WILDE LMFT
NPI 1386334217
Counselor - Mental Health in Santa Rosa, CA

Q: What is Jacqueline Wilde's NPI number?

The NPI number for Jacqueline Wilde is 1386334217. It was assigned to this individual provider in the NPPES registry on May 12, 2023. The provider is also known as Jax Michael Wilde Lmft.

Q: What is Jacqueline Wilde's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jacqueline Wilde was last updated on May 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since May 12, 2023

2107 SIESTA LN, SANTA ROSA, CA 95404(707) 331-9658 Get Directions Write a Review

NPPES record last updated: May 12, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Jacqueline Michael Wilde Lmft NPPES

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

JACQUELINE MICHAEL WILDE LMFT (NPI 1386334217) is an individual mental health provider in Santa Rosa, California, licensed in California (46715) and active in the NPI registry since May 2023.

NPPES Registry Identity

NPI1386334217

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameJACQUELINE MICHAEL WILDECredential: LMFT

Location Address2107 SIESTA LNSanta Rosa, CA 95404-3238

Mailing Address2107 Siesta LnSanta Rosa, CA 95404-3238 · (707) 331-9658

Phone(707) 331-9658

Sole ProprietorYes

Enumeration DateMay 12, 2023

NPPES CertifiedMay 12, 2023

✔ NPI 1386334217 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 · 46715

2107 SIESTA LN, Santa Rosa, CA 95404

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Other Names 1

Other Name (5)Jax Michael Wilde Lmft

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 Jacqueline Wilde's NPI number?

The NPI number for Jacqueline Wilde is 1386334217. It was assigned to this individual provider in the NPPES registry on May 12, 2023. The provider is also known as Jax Michael Wilde Lmft.

Where is Jacqueline Wilde located?

Jacqueline Wilde practices at 2107 Siesta Ln, Santa Rosa, CA 95404. The listed phone number is (707) 331-9658.

What is Jacqueline Wilde'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 Jacqueline Wilde was last updated on May 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.