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General NPI Number Information
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NPI Number | 1528366168
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Entity Type | Individual
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Provider Name | JANET LYNN SP6251
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Gender | Female
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Dates
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Enumeration Date | 03/07/2011
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Last Update Date | 03/07/2011
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Provider Practice Location Address
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Address Line | 5199 E PACIFIC COAST HWY 304N
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City | LONG BEACH
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State | CA
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Zip | 90804-3302
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Country | US
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Telephone | 562-490-0210
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Fax | 562-427-0270
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Provider Business Mailing Address
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Address Line | PO BOX 91073
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City | LONG BEACH
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State | CA
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Zip | 90809-1073
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Country | US
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Telephone | 562-490-0210
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Fax | 562-427-0270
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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 | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number | 6251
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License Number State | CA
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