Provider Demographics
NPI:1801297064
Name:MYERS, JANELLE (MA, ATC)
Entity type:Individual
Prefix:MRS
First Name:JANELLE
Middle Name:
Last Name:MYERS
Suffix:
Gender:F
Credentials:MA, ATC
Other - Prefix:MS
Other - First Name:JANELLE
Other - Middle Name:
Other - Last Name:MANES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4023 W BUENA VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-8415
Mailing Address - Country:US
Mailing Address - Phone:559-901-7931
Mailing Address - Fax:
Practice Address - Street 1:505 ROCKY HILL DR
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:CA
Practice Address - Zip Code:93221-1326
Practice Address - Country:US
Practice Address - Phone:559-901-7931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20000028302255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer