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NPI Code Detail

MEDICARE: JANET FRANCES PARK

MEDICARE: JANET FRANCES PARK
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
1101YM0800XMental Health Counselor
2106H00000XMarriage & Family Therapist104757CA

General Provider Information

NPI Number : 1356623094
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANET FRANCES PARK
Provider Business Mailing Address
First Line : 11731 TELEGRAPH RD STE G
Second Line :
City : SANTA FE SPRINGS
State : CA
Zip : 90670-6819
Country : US
Telephone Number : 562-942-8256
Fax Number :
Provider Business Practice Location Address
First Line : 11731 TELEGRAPH RD STE G
Second Line :
City : SANTA FE SPRINGS
State : CA
Zip : 90670-6819
Country : US
Telephone Number : 562-942-8256
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2011
Last Update Date : 03/17/2018

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Directions to “ JANET FRANCES PARK ” Practice Location

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