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General NPI Number Information
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NPI Number | 1457496440
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Entity Type | Individual
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Provider Name | JOHN PAUL WOLANIN PSY. D.
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Gender | Male
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 08/11/2009
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Provider Practice Location Address
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Address Line | 2555 E COLORADO BLVD SUITE 100
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City | PASADENA
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State | CA
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Zip | 91107-6622
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Country | US
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Telephone | 626-577-2261
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Fax |
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Provider Business Mailing Address
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Address Line | 1610 W 7TH ST APT 308
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City | LOS ANGELES
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State | CA
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Zip | 90017-2229
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Country | US
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Telephone | 330-327-6822
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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