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General NPI Number Information
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NPI Number | 1376735043
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Entity Type | Individual
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Provider Name | JO ANN PANITCH M.F.T.
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Gender | Female
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Dates
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Enumeration Date | 08/15/2007
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Last Update Date | 04/17/2017
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Provider Practice Location Address
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Address Line | 3526 BAHIA BLANCA W UNIT B
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City | LAGUNA WOODS
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State | CA
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Zip | 92637-8444
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Country | US
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Telephone | 310-283-9733
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Fax |
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Provider Business Mailing Address
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Address Line | 3526 BAHIA BLANCA W UNIT B
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City | LAGUNA WOODS
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State | CA
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Zip | 92637-8444
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Country | US
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Telephone | 949-216-7851
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC 44284
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License Number State | CA
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