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NPI Code Detail

MEDICARE: DR. JANICE PATRICIA FERRIS PH.D.

MEDICARE: DR. JANICE PATRICIA FERRIS PH.D.
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
1103TC0700XClinical Psychologist14982CA

General Provider Information

NPI Number : 1083849848
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JANICE PATRICIA FERRIS PH.D.
Provider Business Mailing Address
First Line : 3101 OCEAN PARK BLVD STE 100
Second Line :
City : SANTA MONICA
State : CA
Zip : 90405-3029
Country : US
Telephone Number : 310-804-1743
Fax Number : 424-672-3223
Provider Business Practice Location Address
First Line : 3101 OCEAN PARK BLVD STE 100
Second Line :
City : SANTA MONICA
State : CA
Zip : 90405-3029
Country : US
Telephone Number : 310-804-1743
Fax Number : 424-672-3223
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2009
Last Update Date : 05/31/2021

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