Provider Demographics
NPI:1194021295
Name:BARSOUMIAN, JANET L (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:L
Last Name:BARSOUMIAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 CAMARILLO RANCH RD
Mailing Address - Street 2:SUITE# 209
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-5901
Mailing Address - Country:US
Mailing Address - Phone:805-443-0788
Mailing Address - Fax:805-512-7158
Practice Address - Street 1:400 CAMARILLO RANCH RD
Practice Address - Street 2:SUITE# 209
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93012-5901
Practice Address - Country:US
Practice Address - Phone:805-443-0788
Practice Address - Fax:805-512-7158
Is Sole Proprietor?:No
Enumeration Date:2011-02-07
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP17654235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist