Provider Demographics
NPI:1689964108
Name:JANOUSEK, PETER JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:JAMES
Last Name:JANOUSEK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 LOMBARD ST
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-5808
Mailing Address - Country:US
Mailing Address - Phone:805-495-3811
Mailing Address - Fax:805-494-7733
Practice Address - Street 1:390 LOMBARD ST
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-5808
Practice Address - Country:US
Practice Address - Phone:805-495-3811
Practice Address - Fax:805-494-7733
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-18
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC31845111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor