Provider Demographics
NPI:1487083689
Name:TRAYLOR, JANET (MA, LMFT)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:TRAYLOR
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11956 BERNARDO PLAZA DR # 240
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-2538
Mailing Address - Country:US
Mailing Address - Phone:858-255-0089
Mailing Address - Fax:
Practice Address - Street 1:16935 W BERNARDO DR STE 110
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-1635
Practice Address - Country:US
Practice Address - Phone:858-255-0089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-07
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT104501101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health