Provider Demographics
NPI:1982790960
Name:JANZEN, DANI SKEIE (MPT)
Entity Type:Individual
Prefix:MRS
First Name:DANI
Middle Name:SKEIE
Last Name:JANZEN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:MS
Other - First Name:DANI
Other - Middle Name:CHRISTINE
Other - Last Name:SKEIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:16602 SELL CIRCLE
Mailing Address - Street 2:#50
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649
Mailing Address - Country:US
Mailing Address - Phone:805-798-4026
Mailing Address - Fax:
Practice Address - Street 1:10900 WARNER AVE
Practice Address - Street 2:#111
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708
Practice Address - Country:US
Practice Address - Phone:714-964-3337
Practice Address - Fax:714-964-8806
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT32551225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT32551AOtherMEDICARE PPIN
Q62939Medicare UPIN