Provider Demographics
NPI:1780833814
Name:BURRILL-O'DONNELL, JANELLE LEE (JD, LCSW)
Entity Type:Individual
Prefix:MS
First Name:JANELLE
Middle Name:LEE
Last Name:BURRILL-O'DONNELL
Suffix:
Gender:F
Credentials:JD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 SAND BAR CIR
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-6139
Mailing Address - Country:US
Mailing Address - Phone:916-485-7787
Mailing Address - Fax:916-485-7838
Practice Address - Street 1:915 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-6725
Practice Address - Country:US
Practice Address - Phone:916-646-6500
Practice Address - Fax:916-646-1176
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-12
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 16216101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health