Provider Demographics
NPI:1366336075
Name:OPPITZ, JANIS LEE (EDD, MA, PPS, NCSP)
Entity type:Individual
Prefix:DR
First Name:JANIS
Middle Name:LEE
Last Name:OPPITZ
Suffix:
Gender:F
Credentials:EDD, MA, PPS, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4365 N 160TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-1412
Mailing Address - Country:US
Mailing Address - Phone:530-440-5847
Mailing Address - Fax:
Practice Address - Street 1:4365 N 160TH ST
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-1412
Practice Address - Country:US
Practice Address - Phone:530-440-5847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TB0200X
WI3001029570103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral