Provider Demographics
NPI:1073791497
Name:FOLIANO, JANET SUE (PSYD)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:SUE
Last Name:FOLIANO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 NW WEST HILLS AVE
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-1044
Mailing Address - Country:US
Mailing Address - Phone:541-787-8530
Mailing Address - Fax:541-417-4607
Practice Address - Street 1:376 SW BLUFF DR STE 5
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-1399
Practice Address - Country:US
Practice Address - Phone:541-787-8530
Practice Address - Fax:541-417-4607
Is Sole Proprietor?:No
Enumeration Date:2008-02-07
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3427103TC0700X
OR100240103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500668080Medicaid