Provider Demographics
NPI:1023829793
Name:CHAMBERLAIN ISBELL, JANELLE LERAE
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:LERAE
Last Name:CHAMBERLAIN ISBELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 GATEWAY DR APT 104
Mailing Address - Street 2:
Mailing Address - City:PACIFICA
Mailing Address - State:CA
Mailing Address - Zip Code:94044-1239
Mailing Address - Country:US
Mailing Address - Phone:415-290-7397
Mailing Address - Fax:
Practice Address - Street 1:218 PRIMROSE RD
Practice Address - Street 2:STUDIO 13
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010
Practice Address - Country:US
Practice Address - Phone:415-290-7397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-14
Last Update Date:2025-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA70514225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist