Provider Demographics
NPI:1083391056
Name:JANSSON, ANN CAROLINE
Entity Type:Individual
Prefix:
First Name:ANN CAROLINE
Middle Name:
Last Name:JANSSON
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 1:1848 WILLOW PASS RD STE 207
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-2542
Mailing Address - Country:US
Mailing Address - Phone:310-810-5708
Mailing Address - Fax:
Practice Address - Street 1:1848 WILLOW PASS RD STE 207
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2542
Practice Address - Country:US
Practice Address - Phone:310-810-5708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker