Provider Demographics
NPI:1912776899
Name:OLIVERAS, JANET ANN (PHD)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:ANN
Last Name:OLIVERAS
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 1:1300 E SHAW AVE STE 154
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-7909
Mailing Address - Country:US
Mailing Address - Phone:559-478-6077
Mailing Address - Fax:
Practice Address - Street 1:1300 E SHAW AVE STE 154
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-7909
Practice Address - Country:US
Practice Address - Phone:559-478-6077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16191101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty