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General NPI Number Information
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NPI Number | 1508998857
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Entity Type | Organization
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Legal Business Name | JANICE L. ANDERSON DBA PRIVATE CASE MANAGEMENT SERVICES, CO.
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 11/06/2007
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Provider Practice Location Address
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Address Line | 1434 W SHAW AVE A
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City | FRESNO
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State | CA
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Zip | 93711-3607
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Country | US
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Telephone | 559-227-0931
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Fax | 559-225-6326
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Provider Business Mailing Address
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Address Line | 1434 W SHAW AVE A
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City | FRESNO
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State | CA
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Zip | 93711-3607
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Country | US
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Telephone | 559-227-0931
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Fax | 559-225-6326
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JANICE L. ANDERSON
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Credential | LCSW
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Telephone | 559-227-0931
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | LCS17910
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License Number State | CA
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