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NPI Code Detail

MEDICARE: JANINE CARLSON

MEDICARE: JANINE CARLSON
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
1175T00000XPeer SpecialistCA
2101Y00000XCounselorCG60255508WA

General Provider Information

NPI Number : 1124417696
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANINE CARLSON
Provider Business Mailing Address
First Line : 1147 HARTNELL AVE
Second Line :
City : REDDING
State : CA
Zip : 96002-2113
Country : US
Telephone Number : 530-222-7213
Fax Number : 530-222-7268
Provider Business Practice Location Address
First Line : 1147 HARTNELL AVE
Second Line :
City : REDDING
State : CA
Zip : 96002-2113
Country : US
Telephone Number : 530-222-7213
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2015
Last Update Date : 12/03/2025

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Directions to “ JANINE CARLSON ” Practice Location

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