Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Jaclyn Dietzold, MD

Individual provider Psychiatry Physician · NPI 1194138826

Dr. Jaclyn Dietzold, MD is a Psychiatry in Philadelphia, Pennsylvania. Qualified in 2014, 12 years ago. Practices with Temple Faculty Practice Plan Inc, a 1,314-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
12
Licensed in
PA
In the registry since
2014
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

100 E Lehigh Ave
Philadelphia, PA 19125-1012
Phone: (215) 707-8496
Fax: (215) 707-4086
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence MD470050 (PA)
Psychiatry Physician Taxonomy 2084P0800X · Licence MT207389 (PA)

Record details

NPI number1194138826
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorYes
NPI enumeratedJune 10, 2014
Last updated in NPPESJuly 15, 2020
Certification dateJuly 15, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPSYCHIATRY
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Temple Faculty Practice Plan Inc — 1314 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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