Provider Demographics
NPI:1003031915
Name:DUGAN, JANIS B (PT)
Entity Type:Individual
Prefix:
First Name:JANIS
Middle Name:B
Last Name:DUGAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1980 OLD MISSION DR
Mailing Address - Street 2:SUITE C-1
Mailing Address - City:SOLVANG
Mailing Address - State:CA
Mailing Address - Zip Code:93463-2262
Mailing Address - Country:US
Mailing Address - Phone:805-686-1934
Mailing Address - Fax:
Practice Address - Street 1:1980 OLD MISSION DR
Practice Address - Street 2:SUITE C-1
Practice Address - City:SOLVANG
Practice Address - State:CA
Practice Address - Zip Code:93463-2262
Practice Address - Country:US
Practice Address - Phone:805-686-1934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT8174A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT8174AOtherPPIN
CAW17211OtherMC GROUP NUMBER