Provider Demographics
NPI:1669537361
Name:GUGLIELMINO, JANET MARIE (PHD)
Entity type:Individual
Prefix:DR
First Name:JANET
Middle Name:MARIE
Last Name:GUGLIELMINO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 JULIAN ST
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-8202
Mailing Address - Country:US
Mailing Address - Phone:760-872-4000
Mailing Address - Fax:530-338-2858
Practice Address - Street 1:612 JULIAN ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003
Practice Address - Country:US
Practice Address - Phone:760-872-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-25
Last Update Date:2021-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA PSY 13695103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACAPSY 13695OtherPSYCHOLOGIST LICENSE
CACAPSY 13695OtherPSYCHOLOGIST LICENSE