Provider Demographics
NPI:1104606136
Name:UGARRIZA, JANICE
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:UGARRIZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:MARIE
Other - Last Name:RIVERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:108 BRITTANY DR
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-2332
Mailing Address - Country:US
Mailing Address - Phone:845-807-8216
Mailing Address - Fax:
Practice Address - Street 1:108 BRITTANY DR
Practice Address - Street 2:
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914-2332
Practice Address - Country:US
Practice Address - Phone:845-807-8216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010210101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional