Basic Information
| Provider Information | |||||||||
| NPI: | 1003100892 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REED | ||||||||
| FirstName: | JANINE | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | M.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 777 W MIDDLEFIELD RD | ||||||||
| Address2: | APT 65 | ||||||||
| City: | MOUNTAIN VIEW | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940433302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6508623101 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1885 LUNDY AVE | ||||||||
| Address2: | 223 | ||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951311887 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4082849010 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2011 | ||||||||
| LastUpdateDate: | 04/03/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | N | Other Service Providers | Case Manager/Care Coordinator | 106H00000X | IMF61902 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.