Provider Demographics
NPI:1154195311
Name:LANFAIR, JANELLE
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:
Last Name:LANFAIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JANELLE
Other - Middle Name:
Other - Last Name:CARVALHO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:350 FAIRWAY DR STE 101
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-1834
Mailing Address - Country:US
Mailing Address - Phone:877-418-2978
Mailing Address - Fax:
Practice Address - Street 1:8407 CORONA VISTA WAY
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-3864
Practice Address - Country:US
Practice Address - Phone:916-792-3513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician