1275708901 NPI number — MRS. JANICE VICTORIA SCHMIDT RN, MFT

Table of content: MRS. JANICE VICTORIA SCHMIDT RN, MFT (NPI 1275708901)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275708901 NPI number — MRS. JANICE VICTORIA SCHMIDT RN, MFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHMIDT
Provider First Name:
JANICE
Provider Middle Name:
VICTORIA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RN, MFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SCHMIDT
Provider Other First Name:
VICKI
Provider Other Middle Name:
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN, MFT
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1275708901
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/09/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15837 ECCLES ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH HILLS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91343-6318
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-893-4084
Provider Business Mailing Address Fax Number:
818-893-4084

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9659 BALBOA BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTHRIDGE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91325-1902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-893-4084
Provider Business Practice Location Address Fax Number:
818-893-4084
Provider Enumeration Date:
04/23/2008

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: 106H00000X , with the licence number:  MFC 31400 , 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)





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