Provider Demographics
NPI:1083849848
Name:FERRIS, JANICE PATRICIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:JANICE
Middle Name:PATRICIA
Last Name:FERRIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 OCEAN PARK BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-3029
Mailing Address - Country:US
Mailing Address - Phone:310-804-1743
Mailing Address - Fax:424-672-3223
Practice Address - Street 1:3101 OCEAN PARK BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90405-3029
Practice Address - Country:US
Practice Address - Phone:310-804-1743
Practice Address - Fax:424-672-3223
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-22
Last Update Date:2021-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14982103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty