Provider Demographics
NPI:1811221013
Name:JANET LEE WHITNEY A MARRIAGE AND FAMILY THERAPY CORPORATION
Entity Type:Organization
Organization Name:JANET LEE WHITNEY A MARRIAGE AND FAMILY THERAPY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:MS
Authorized Official - First Name:MAGGIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:STILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-245-3968
Mailing Address - Street 1:1151 DOVE ST STE 245
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2806
Mailing Address - Country:US
Mailing Address - Phone:949-677-9280
Mailing Address - Fax:949-786-2040
Practice Address - Street 1:1151 DOVE ST STE 245
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2806
Practice Address - Country:US
Practice Address - Phone:949-677-9280
Practice Address - Fax:949-786-2040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-22
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT18675106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty