Provider Demographics
NPI:1366447229
Name:PIERUCCI, JANET B (PH D)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:B
Last Name:PIERUCCI
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:146 SAN JOSE CT
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93405-1532
Mailing Address - Country:US
Mailing Address - Phone:805-845-8989
Mailing Address - Fax:805-544-0863
Practice Address - Street 1:5901 ENCINA RD STE A
Practice Address - Street 2:
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93117-2270
Practice Address - Country:US
Practice Address - Phone:805-845-8989
Practice Address - Fax:805-544-0863
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY12731103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PL127310Medicare ID - Type UnspecifiedPSYCHOLOGIST