Provider Demographics
NPI:1427819440
Name:DOLRAYNE, JANELLE HOULEMARDE
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:HOULEMARDE
Last Name:DOLRAYNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5622 S VERDUN AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90043-2124
Mailing Address - Country:US
Mailing Address - Phone:303-253-1193
Mailing Address - Fax:
Practice Address - Street 1:444 N LARCHMONT BLVD STE 203
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004-3030
Practice Address - Country:US
Practice Address - Phone:303-253-1193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT136917101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health