1205901667 NPI number — MS. JANICE ANNETTE LASHLEY ACSW

Table of content: MS. JANICE ANNETTE LASHLEY ACSW (NPI 1205901667)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205901667 NPI number — MS. JANICE ANNETTE LASHLEY ACSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LASHLEY
Provider First Name:
JANICE
Provider Middle Name:
ANNETTE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
ACSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205901667
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1808 MODOC DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHICO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95928
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
530-893-5833
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5910 CLARK ROAD
Provider Second Line Business Practice Location Address:
SUITES H - I
Provider Business Practice Location Address City Name:
PARADISE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95969
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-872-6325
Provider Business Practice Location Address Fax Number:
530-872-5970
Provider Enumeration Date:
11/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  ASW 8952 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: ASW8952 . This is a "BOARD OF BEHAVIORAL SCIEN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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