Provider Demographics
NPI:1225211824
Name:MCDANIEL, JANICE V
Entity Type:Individual
Prefix:MS
First Name:JANICE
Middle Name:V
Last Name:MCDANIEL
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 1:9150 EAST IMPERIAL HIGHWAY
Mailing Address - Street 2:ROOM R31
Mailing Address - City:DORONEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242
Mailing Address - Country:US
Mailing Address - Phone:562-940-3694
Mailing Address - Fax:562-658-4725
Practice Address - Street 1:415 WEST OCEAN BLVD
Practice Address - Street 2:#100
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802
Practice Address - Country:US
Practice Address - Phone:562-491-5811
Practice Address - Fax:562-983-5747
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management