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General NPI Number Information
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NPI Number | 1962937847
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Entity Type | Individual
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Provider Name | JANELLE RENEE MARAVELIAS DPM
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Gender | Female
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Dates
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Enumeration Date | 04/27/2017
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Last Update Date | 02/01/2025
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Provider Practice Location Address
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Address Line | 901 CAMPUS DR STE 111
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City | DALY CITY
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State | CA
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Zip | 94015-4930
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Country | US
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Telephone | 650-652-7060
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Fax | 650-652-8701
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Provider Business Mailing Address
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Address Line | 901 CAMPUS DR STE 111
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City | DALY CITY
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State | CA
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Zip | 94015-4930
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Country | US
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Telephone | 650-652-7060
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Fax | 650-652-8701
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E5670
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License Number State | CA
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