Provider Demographics
NPI:1417307992
Name:JANSSEN, NEAL EDWARD (LCSW)
Entity Type:Individual
Prefix:
First Name:NEAL
Middle Name:EDWARD
Last Name:JANSSEN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:NEAL
Other - Middle Name:
Other - Last Name:JANSSEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 2552
Mailing Address - Street 2:2929 WESTMINSTER AVE
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-1552
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9333 IMPERIAL HWY
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-2812
Practice Address - Country:US
Practice Address - Phone:562-657-8590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-15
Last Update Date:2016-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA712641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical