Healthcare Provider Details
I. General information
NPI: 1801988050
Provider Name (Legal Business Name): JANET CYNTHIA CONNEY MD, INC.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/28/2006
Last Update Date: 05/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12062 VALLEY VIEW STREET SUITE 129
GARDEN GROVE CA
92845
US
IV. Provider business mailing address
12062 VALLEY VIEW STREET SUITE 129
GARDEN GROVE CA
92845
US
V. Phone/Fax
- Phone: 562-342-3006
- Fax: 562-206-0042
- Phone: 562-342-3006
- Fax: 562-206-0042
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0805X |
| Taxonomy | Geriatric Psychiatry Physician |
| License Number | A55794 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: