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General NPI Number Information
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NPI Number | 1689726747
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Entity Type | Individual
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Provider Name | JANIS ELAINE FOOTE PH.D.
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Gender | Female
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3532 KATELLA AVE STE. 231
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-3112
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Country | US
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Telephone | 562-682-8066
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Fax | 562-596-3838
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Provider Business Mailing Address
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Address Line | 3532 KATELLA AVE STE. 231
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-3112
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Country | US
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Telephone | 562-682-8066
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Fax | 562-596-3838
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY5810
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License Number State | CA
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