Provider Demographics
NPI:1881725653
Name:JANETZKE, BARBARA LOUISE (PHD)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:LOUISE
Last Name:JANETZKE
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 1:1 W CALIFORNIA BLVD
Mailing Address - Street 2:SUITE #321
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3029
Mailing Address - Country:US
Mailing Address - Phone:626-255-7512
Mailing Address - Fax:
Practice Address - Street 1:1 W CALIFORNIA BLVD
Practice Address - Street 2:SUITE #321
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3029
Practice Address - Country:US
Practice Address - Phone:626-255-7512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY20188103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical