Provider Demographics
NPI:1922485176
Name:WELLS, JANET (LAC)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:
Last Name:WELLS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16776 BERNARDO CENTER DR STE 211
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-2559
Mailing Address - Country:US
Mailing Address - Phone:858-333-6633
Mailing Address - Fax:858-408-7563
Practice Address - Street 1:16776 BERNARDO CENTER DR STE 211
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2559
Practice Address - Country:US
Practice Address - Phone:858-333-6633
Practice Address - Fax:858-408-7563
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-27
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16512171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist