MEDICARE: MS. ALICE KING JANIK L.M.F.T.

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	MFC31001	CA

General Provider Information

NPI Number	:	1225000128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ALICE KING JANIK L.M.F.T.

Provider Business Mailing Address
First Line	:	41750 RANCHO LAS PALMAS DR
Second Line	:	SUITE C3
City	:	RANCHO MIRAGE
State	:	CA
Zip	:	92270-5511
Country	:	US
Telephone Number	:	760-776-4770
Fax Number	:	760-776-4772

Provider Business Practice Location Address
First Line	:	41750 RANCHO LAS PALMAS DR
Second Line	:	SUITE C3
City	:	RANCHO MIRAGE
State	:	CA
Zip	:	92270-5511
Country	:	US
Telephone Number	:	760-776-4770
Fax Number	:	760-776-4772

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

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	07/08/2007

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Directions to “ MS. ALICE KING JANIK L.M.F.T.” Practice Location

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