Provider Demographics
NPI:1033891866
Name:JANKEEL, NOOR
Entity Type:Individual
Prefix:MS
First Name:NOOR
Middle Name:
Last Name:JANKEEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9353 CARLTON OAKS DR APT 119
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-2568
Mailing Address - Country:US
Mailing Address - Phone:619-760-6206
Mailing Address - Fax:
Practice Address - Street 1:875 EL CAJON BLVD
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-5714
Practice Address - Country:US
Practice Address - Phone:619-806-1054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-02
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAF1768177104100000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No104100000XBehavioral Health & Social Service ProvidersSocial Worker