Provider Demographics
NPI:1417069139
Name:AGOSTI, JANET M (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:M
Last Name:AGOSTI
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:M
Other - Last Name:SUMMERFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:428 HARRISON AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-4605
Mailing Address - Country:US
Mailing Address - Phone:909-941-0781
Mailing Address - Fax:909-980-2252
Practice Address - Street 1:428 HARRISON AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-4605
Practice Address - Country:US
Practice Address - Phone:909-941-0781
Practice Address - Fax:909-980-2252
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 121611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical