Provider Demographics
NPI:1215236781
Name:SEIBERLICH, JANIS (MFT)
Entity type:Individual
Prefix:
First Name:JANIS
Middle Name:
Last Name:SEIBERLICH
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 SHERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94043-3800
Mailing Address - Country:US
Mailing Address - Phone:650-810-5680
Mailing Address - Fax:
Practice Address - Street 1:61 RENATO CT
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94061-4093
Practice Address - Country:US
Practice Address - Phone:650-810-5680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-23
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC48387106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist