Provider Demographics
NPI:1407848229
Name:REED-MASSMAN, JANET R (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:R
Last Name:REED-MASSMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 ARROYO VIS
Mailing Address - Street 2:
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92028-2478
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:577 E ELDER ST
Practice Address - Street 2:STE F
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-3079
Practice Address - Country:US
Practice Address - Phone:760-451-1950
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS205591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA264037OtherMANAGED HEALTH NET
CALCS205590OtherBLUE SHIELD
CA550010002286OtherPACIFICARE
CA7991OtherMINES & ASSOCIATES
CALCS205590OtherTRICARE
CASW20559Medicare ID - Type Unspecified
CAS84525Medicare UPIN