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General NPI Number Information
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NPI Number | 1013023605
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Entity Type | Individual
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Provider Name | JANNA ODDIE CAVANAUGH PSY D
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Gender | Female
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 01/24/2020
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Provider Practice Location Address
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Address Line | 305 N HEATHERWILDE BLVD STE 310
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City | PFLUGERVILLE
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State | TX
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Zip | 78660-4195
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Country | US
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Telephone | 512-787-9595
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Fax |
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Provider Business Mailing Address
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Address Line | 305 N HEATHERWILDE BLVD STE 310
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City | PFLUGERVILLE
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State | TX
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Zip | 78660-4195
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Country | US
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Telephone | 512-704-8349
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY18378
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 33590
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License Number State | TX
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