Provider Demographics
NPI:1851492052
Name:CONCEPCION, JANETTE FAYE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JANETTE
Middle Name:FAYE
Last Name:CONCEPCION
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6230 10TH ST N
Mailing Address - Street 2:SUITE 310-B
Mailing Address - City:OAKDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55128-6158
Mailing Address - Country:US
Mailing Address - Phone:651-714-2000
Mailing Address - Fax:651-714-4400
Practice Address - Street 1:6230 10TH ST N
Practice Address - Street 2:SUITE 310-B
Practice Address - City:OAKDALE
Practice Address - State:MN
Practice Address - Zip Code:55128-6158
Practice Address - Country:US
Practice Address - Phone:651-714-2000
Practice Address - Fax:651-714-4400
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNLP2958103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN103577OtherHEALTH PARTNERS OF MN
MN453T3COOtherBLUE CROSS BLUE SHIELD MN
MN990991023407OtherPREFERRED ONE OF MN
MN6190337OtherUNITED BEHAVIORAL HEALTH