Provider Demographics
NPI:1215335112
Name:MILL, JANICE D (PHD)
Entity type:Individual
Prefix:DR
First Name:JANICE
Middle Name:D
Last Name:MILL
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 1:550 HAMILTON AVE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-2010
Mailing Address - Country:US
Mailing Address - Phone:650-325-6834
Mailing Address - Fax:650-328-6600
Practice Address - Street 1:550 HAMILTON AVE
Practice Address - Street 2:SUITE 240
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2010
Practice Address - Country:US
Practice Address - Phone:650-325-6834
Practice Address - Fax:650-328-6600
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-09
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY10679103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist