Provider Demographics
NPI:1134682008
Name:JANZ FAMILY THERAPY INCORPORATED
Entity Type:Organization
Organization Name:JANZ FAMILY THERAPY INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:WALKER
Authorized Official - Last Name:JANZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:559-825-1205
Mailing Address - Street 1:2037 W BULLARD AVE # 245
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-1200
Mailing Address - Country:US
Mailing Address - Phone:559-786-8794
Mailing Address - Fax:
Practice Address - Street 1:1357 W SHAW AVE STE 100
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3619
Practice Address - Country:US
Practice Address - Phone:559-825-1205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-09
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA578531OtherMHN
CA1659781391Medicaid
CA1659781392OtherANTHEM MEDICAL