Provider Demographics
NPI:1215164454
Name:SCHROTH, JANINE WOODWARD (PHD)
Entity type:Individual
Prefix:DR
First Name:JANINE
Middle Name:WOODWARD
Last Name:SCHROTH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 QUAIL ST
Mailing Address - Street 2:SUITE 260
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2732
Mailing Address - Country:US
Mailing Address - Phone:949-222-2848
Mailing Address - Fax:
Practice Address - Street 1:1500 QUAIL ST
Practice Address - Street 2:SUITE 260
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2732
Practice Address - Country:US
Practice Address - Phone:949-222-2848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-15
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY13039103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral