Provider Demographics
NPI:1457462350
Name:CLICK, JAN MARIE (MSW)
Entity Type:Individual
Prefix:MS
First Name:JAN
Middle Name:MARIE
Last Name:CLICK
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25852 MCBEAN PKWY
Mailing Address - Street 2:SUITE 412
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-2004
Mailing Address - Country:US
Mailing Address - Phone:661-632-2551
Mailing Address - Fax:661-554-3253
Practice Address - Street 1:28494 WESTINGHOUSE PL
Practice Address - Street 2:SUITE 203
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-0930
Practice Address - Country:US
Practice Address - Phone:661-632-2551
Practice Address - Fax:661-554-3253
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 146891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical