Provider Demographics
NPI:1295458982
Name:CARNEY-CLARK, JANET LYNN
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:LYNN
Last Name:CARNEY-CLARK
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 1:26120 ALIZIA CANYON DR UNIT B
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-2632
Mailing Address - Country:US
Mailing Address - Phone:181-888-0855
Mailing Address - Fax:
Practice Address - Street 1:32129 LINDERO CANYON RD STE 202
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-5466
Practice Address - Country:US
Practice Address - Phone:818-746-6950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT27725106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist