Provider Demographics
NPI:1114017431
Name:ENGLERT, JANICE CATHERINE (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:CATHERINE
Last Name:ENGLERT
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:J
Other - Last Name:ENGLERT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, LMFT
Mailing Address - Street 1:1625 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:SOLVANG
Mailing Address - State:CA
Mailing Address - Zip Code:93463-2622
Mailing Address - Country:US
Mailing Address - Phone:805-698-4565
Mailing Address - Fax:805-737-9161
Practice Address - Street 1:205 N H ST
Practice Address - Street 2:SUITE 203
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-6026
Practice Address - Country:US
Practice Address - Phone:805-698-4565
Practice Address - Fax:805-737-9161
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC40126106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist