MEDICARE: MS. JANET R REED-MASSMAN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LCS20559	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	264037	OTHER	CA	MANAGED HEALTH NET
2	LCS205590	OTHER	CA	BLUE SHIELD
3	550010002286	OTHER	CA	PACIFICARE
4	7991	OTHER	CA	MINES & ASSOCIATES
5	LCS205590	OTHER	CA	TRICARE

General Provider Information

NPI Number	:	1407848229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JANET R REED-MASSMAN LCSW

Provider Business Mailing Address
First Line	:	318 ARROYO VIS
Second Line	:
City	:	FALLBROOK
State	:	CA
Zip	:	92028-2478
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	577 E ELDER ST
Second Line	:	STE F
City	:	FALLBROOK
State	:	CA
Zip	:	92028-3079
Country	:	US
Telephone Number	:	760-451-1950
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2005
Last Update Date	:	07/08/2007

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