Provider Demographics
NPI:1417142936
Name:LITWAK, JANELLE VICTORIA (MS MFT)
Entity Type:Individual
Prefix:MS
First Name:JANELLE
Middle Name:VICTORIA
Last Name:LITWAK
Suffix:
Gender:F
Credentials:MS MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 90581
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91109
Mailing Address - Country:US
Mailing Address - Phone:626-710-0143
Mailing Address - Fax:866-401-2658
Practice Address - Street 1:16 S OAKLAND AVE
Practice Address - Street 2:STE 212
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101
Practice Address - Country:US
Practice Address - Phone:626-710-0143
Practice Address - Fax:866-401-2658
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACALMFT40387106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist