Provider Demographics
NPI:1689726747
Name:FOOTE, JANIS ELAINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JANIS
Middle Name:ELAINE
Last Name:FOOTE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3532 KATELLA AVE
Mailing Address - Street 2:STE. 231
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3112
Mailing Address - Country:US
Mailing Address - Phone:562-682-8066
Mailing Address - Fax:562-596-3838
Practice Address - Street 1:3532 KATELLA AVE
Practice Address - Street 2:STE. 231
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3112
Practice Address - Country:US
Practice Address - Phone:562-682-8066
Practice Address - Fax:562-596-3838
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY5810103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical