Healthcare Provider Details

I. General information

NPI: 1841324274
Provider Name (Legal Business Name): JA NE'T MICHELLE ROMMERO PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 04/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5701 W SLAUSON AVE
LOS ANGELES CA
90230-6523
US

IV. Provider business mailing address

PO BOX 881988
LOS ANGELES CA
90009-3018
US

V. Phone/Fax

Practice location:
  • Phone: 323-744-1457
  • Fax:
Mailing address:
  • Phone: 323-744-1457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL
# 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: