Provider Demographics
NPI:1801330345
Name:JANE LI MD PSYCHIATRY, INC.
Entity type:Organization
Organization Name:JANE LI MD PSYCHIATRY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-256-5527
Mailing Address - Street 1:290 MAPLE CT
Mailing Address - Street 2:SUITE 107
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-3517
Mailing Address - Country:US
Mailing Address - Phone:805-256-5527
Mailing Address - Fax:
Practice Address - Street 1:290 MAPLE CT
Practice Address - Street 2:SUITE 107
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-3517
Practice Address - Country:US
Practice Address - Phone:805-256-5527
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-16
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1042982084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty