Provider Demographics
NPI:1750947784
Name:MATTHEWS, JANET MARIE (LMFT)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:MARIE
Last Name:MATTHEWS
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 1:2801 BROSNAN ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-5604
Mailing Address - Country:US
Mailing Address - Phone:619-723-0049
Mailing Address - Fax:
Practice Address - Street 1:8250 VICKERS ST STE H
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-2117
Practice Address - Country:US
Practice Address - Phone:858-384-6042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-15
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA104749106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist