Provider Demographics
NPI:1275001679
Name:JANET JOHNSTON-TYLER
Entity Type:Organization
Organization Name:JANET JOHNSTON-TYLER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSTON-TYLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-735-7990
Mailing Address - Street 1:4655 OLD IRONSIDES DR STE 170
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95054-1853
Mailing Address - Country:US
Mailing Address - Phone:408-735-7990
Mailing Address - Fax:888-735-7991
Practice Address - Street 1:4655 OLD IRONSIDES DR.
Practice Address - Street 2:SUITE 170
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95054
Practice Address - Country:US
Practice Address - Phone:408-735-7990
Practice Address - Fax:888-735-7991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-05
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty