Healthcare Provider Details

I. General information

NPI: 1346930005
Provider Name (Legal Business Name): JANELLE BOYCE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2023
Last Update Date: 10/03/2023
Certification Date: 10/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 S LA CIENEGA BLVD STE 300
BEVERLY HILLS CA
90211-3356
US

IV. Provider business mailing address

900 W TEMPLE ST APT 408B
LOS ANGELES CA
90012-4548
US

V. Phone/Fax

Practice location:
  • Phone: 310-362-8179
  • Fax:
Mailing address:
  • Phone: 416-625-1132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number109482
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: