Healthcare Provider Details

I. General information

NPI: 1457722712
Provider Name (Legal Business Name): JANAELYN LASHAE MITCHELL LMFT #135096
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2015
Last Update Date: 11/30/2022
Certification Date: 11/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 E YALE AVE
FRESNO CA
93704-6238
US

IV. Provider business mailing address

2803 ALMOND AVE
SANGER CA
93657-8754
US

V. Phone/Fax

Practice location:
  • Phone: 559-252-1738
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number112165
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number135096
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: