Provider Demographics
NPI:1295778868
Name:SCHMIDT, JANICE ANTONELLI (LMFT)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:ANTONELLI
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1483 OLYMPUS AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94708-2207
Mailing Address - Country:US
Mailing Address - Phone:510-841-3922
Mailing Address - Fax:510-841-4927
Practice Address - Street 1:20284 REDWOOD RD
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-4312
Practice Address - Country:US
Practice Address - Phone:510-841-3922
Practice Address - Fax:510-841-4927
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2009-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC37550106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist