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General NPI Number Information
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NPI Number | 1295778868
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Entity Type | Individual
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Provider Name | JANICE ANTONELLI SCHMIDT LMFT
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Gender | Female
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 04/13/2009
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Provider Practice Location Address
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Address Line | 20284 REDWOOD RD
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-4312
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Country | US
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Telephone | 510-841-3922
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Fax | 510-841-4927
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Provider Business Mailing Address
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Address Line | 1483 OLYMPUS AVE
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City | BERKELEY
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State | CA
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Zip | 94708-2207
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Country | US
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Telephone | 510-841-3922
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Fax | 510-841-4927
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC37550
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License Number State | CA
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