Provider Demographics
NPI:1376050476
Name:GALINANES, JAN GABRIELLE (LMFT, ATR-BC)
Entity Type:Individual
Prefix:
First Name:JAN GABRIELLE
Middle Name:
Last Name:GALINANES
Suffix:
Gender:F
Credentials:LMFT, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3088 BAZE RD UNIT 115
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-3576
Mailing Address - Country:US
Mailing Address - Phone:417-379-4031
Mailing Address - Fax:
Practice Address - Street 1:2015 PIONEER CT STE B
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-1736
Practice Address - Country:US
Practice Address - Phone:650-348-6603
Practice Address - Fax:650-638-1602
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-10
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95016106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist