MEDICARE: DR. JANICE WACHTEL 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
1	103TC0700X	Clinical Psychologist	PY0005827	FL

General Provider Information

NPI Number	:	1134235641
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANICE WACHTEL PH.D.

Provider Business Mailing Address
First Line	:	100 EXECUTIVE WAY
Second Line	:	STE 110
City	:	PONTE VEDRA BEACH
State	:	FL
Zip	:	32082-4753
Country	:	US
Telephone Number	:	904-834-2235
Fax Number	:	866-531-8858

Provider Business Practice Location Address
First Line	:	100 EXECUTIVE WAY
Second Line	:	STE 110
City	:	PONTE VEDRA BEACH
State	:	FL
Zip	:	32082-4753
Country	:	US
Telephone Number	:	904-834-2235
Fax Number	:	866-531-8858

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

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	02/03/2022

Similar Medicare Providers

1144207713 — ETTA F. ETTLINGER LCSW
Practice Location Address:

100 EXECUTIVE WAY , SUITE #110
PONTE VEDRA, FL
32082-4753

Practice Phone: 904-273-4099
Practice Fax: 904-273-4095

1932384351 — ETTA ETTLINGER, LCSW, PA
Practice Location Address:

100 EXECUTIVE WAY STE 110
PONTE VEDRA, FL
32082-4753

Practice Phone: 904-273-4099
Practice Fax: 904-273-4095

1306952130 — DR. AARON P GERSON D.D.S.
Practice Location Address:

1221 HIGHLAND AVE
MANHATTAN BEACH, CA
90266-4753

Practice Phone: 310-545-4561
Practice Fax: 310-545-4562

1144360454 — ELEANORA MARIE WOLOY M.D.
Practice Location Address:

833 DE LA FAYETTE CT
VIRGINIA BEACH, VA
23455-4753

Practice Phone: 757-499-4446
Practice Fax:

1154703189 — ENJOLI PAGE FILEMU OTD, OTR/L, CPAM
Practice Location Address:

16761 VIEWPOINT LN APT 3
HUNTINGTON BEACH, CA
92647-4753

Practice Phone: 626-755-4412
Practice Fax:

1649706946 — KATHY ALVEAR BCBA
Practice Location Address:

612 REYNOLDS LN
REDONDO BEACH, CA
90278-4753

Practice Phone: 973-819-9975
Practice Fax:

Directions to “ DR. JANICE WACHTEL PH.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.