Basic Information
Provider Information
NPI: 1891098059
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: YANEZ
FirstName: JANET
MiddleName: JOSEFINA
NamePrefix:  
NameSuffix:  
Credential: M.A., LMFT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1721 GRIFFIN AVE
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900313312
CountryCode: US
TelephoneNumber: 3232214134
FaxNumber:  
Practice Location
Address1: 1721 GRIFFIN AVE
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900313312
CountryCode: US
TelephoneNumber: 3232214134
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/09/2010
LastUpdateDate: 12/31/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000X CAN Behavioral Health & Social Service ProvidersMarriage & Family Therapist 
106H00000X84482CAY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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