Provider Demographics
NPI:1376661801
Name:JUSTUS, JANICE E (MHAIII)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:E
Last Name:JUSTUS
Suffix:
Gender:F
Credentials:MHAIII
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:E
Other - Last Name:CARWILE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7528 LOMA RIO LN
Mailing Address - Street 2:
Mailing Address - City:NORTH HIGHLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:95660-2729
Mailing Address - Country:US
Mailing Address - Phone:916-393-1222
Mailing Address - Fax:
Practice Address - Street 1:4600 47TH AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95824-3923
Practice Address - Country:US
Practice Address - Phone:916-393-1222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health