Provider Demographics
NPI:1659798171
Name:HARRIS, JANAI
Entity Type:Individual
Prefix:
First Name:JANAI
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JANAI
Other - Middle Name:
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3000 W. CECIL AVE.
Mailing Address - Street 2:MENTAL HEALTH DEPT.
Mailing Address - City:DELANO
Mailing Address - State:CA
Mailing Address - Zip Code:93215
Mailing Address - Country:US
Mailing Address - Phone:661-721-6300
Mailing Address - Fax:
Practice Address - Street 1:3000 W. CECIL AVE.
Practice Address - Street 2:MENTAL HEALTH DEPT.
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215
Practice Address - Country:US
Practice Address - Phone:661-721-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-21
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA807901041C0700X
CA34614103T00000X
IL149.0193391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL149.019339OtherLICENSED CLINICAL SOCIAL WORKER
CA80790OtherLICENSED CLINICAL SOCIAL WORKER
CA34614OtherCA BOARD OF PSYCHOLOGY