MEDICARE: JANET ELIZABETH PINNEAU MFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	47355	CA

General Provider Information

NPI Number	:	1053732354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANET ELIZABETH PINNEAU MFT

Provider Business Mailing Address
First Line	:	9420 RESEDA BLVD
Second Line	:	#305
City	:	NORTHRIDGE
State	:	CA
Zip	:	91324-2932
Country	:	US
Telephone Number	:	818-885-8932
Fax Number	:

Provider Business Practice Location Address
First Line	:	9003 RESEDA BLVD
Second Line	:	#208
City	:	NORTHRIDGE
State	:	CA
Zip	:	91324-3920
Country	:	US
Telephone Number	:	818-885-8932
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2014
Last Update Date	:	01/04/2014

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