Provider Demographics
NPI:1285086157
Name:MILLEN, JANELLE-CHERI ANGELLA (MB BS)
Entity type:Individual
Prefix:MS
First Name:JANELLE-CHERI
Middle Name:ANGELLA
Last Name:MILLEN
Suffix:
Gender:F
Credentials:MB BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 GEORGIA AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20059
Mailing Address - Country:US
Mailing Address - Phone:571-865-6100
Mailing Address - Fax:
Practice Address - Street 1:2121 SANTA MONICA BLVD
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2303
Practice Address - Country:US
Practice Address - Phone:310-315-6125
Practice Address - Fax:310-582-7163
Is Sole Proprietor?:No
Enumeration Date:2016-07-05
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA178504208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program