Provider Demographics
NPI:1194754440
Name:JANSEN, FRANCINE LORRAINE (LCSW)
Entity type:Individual
Prefix:MS
First Name:FRANCINE
Middle Name:LORRAINE
Last Name:JANSEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 NIPOMO STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401
Mailing Address - Country:US
Mailing Address - Phone:805-541-7911
Mailing Address - Fax:805-595-7989
Practice Address - Street 1:1124 NIPOMO STREET
Practice Address - Street 2:SUITE A
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401
Practice Address - Country:US
Practice Address - Phone:805-541-7911
Practice Address - Fax:805-595-7989
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS142921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical