Provider Demographics
NPI:1013800739
Name:JANNI, MARCIA SHARON
Entity type:Individual
Prefix:
First Name:MARCIA
Middle Name:SHARON
Last Name:JANNI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARCEY
Other - Middle Name:
Other - Last Name:GRANT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3680 WILSHIRE BLVD
Mailing Address - Street 2:STE PO4 #1440
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010
Mailing Address - Country:US
Mailing Address - Phone:310-497-0064
Mailing Address - Fax:
Practice Address - Street 1:3680 WILSHIRE BLVD
Practice Address - Street 2:STE PO4 #1440
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010
Practice Address - Country:US
Practice Address - Phone:310-497-0064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier