Provider Demographics
NPI:1033988084
Name:MARONEY, JANINE LISETT
Entity Type:Individual
Prefix:
First Name:JANINE
Middle Name:LISETT
Last Name:MARONEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JANINE
Other - Middle Name:LISSETT
Other - Last Name:LESSLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:44046 BOGARD CT
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-6271
Mailing Address - Country:US
Mailing Address - Phone:661-571-6308
Mailing Address - Fax:
Practice Address - Street 1:7313 WHITTIER AVE
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-1132
Practice Address - Country:US
Practice Address - Phone:424-442-9129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-01
Last Update Date:2024-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPTA50016225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant