Provider Demographics
NPI:1336429893
Name:FIELDS, JANEECE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:JANEECE
Middle Name:
Last Name:FIELDS
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 1:7704 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:SEBASTOPOL
Mailing Address - State:CA
Mailing Address - Zip Code:95472-3628
Mailing Address - Country:US
Mailing Address - Phone:808-342-5037
Mailing Address - Fax:
Practice Address - Street 1:435 PETALUMA AVE
Practice Address - Street 2:
Practice Address - City:SEBASTOPOL
Practice Address - State:CA
Practice Address - Zip Code:95472-4277
Practice Address - Country:US
Practice Address - Phone:808-342-5037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-27
Last Update Date:2017-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA#17640106H00000X
HI#3106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist