Provider Demographics
NPI:1053779298
Name:SCIORTINO, JODY E (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JODY
Middle Name:E
Last Name:SCIORTINO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1521 ROMA DR
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081-5030
Mailing Address - Country:US
Mailing Address - Phone:760-697-2873
Mailing Address - Fax:760-860-5959
Practice Address - Street 1:2204 S EL CAMINO REAL STE 305
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-6306
Practice Address - Country:US
Practice Address - Phone:760-697-2873
Practice Address - Fax:760-860-5959
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-02
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW696191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical