Provider Demographics
NPI:1588994073
Name:SEIB, JANICE BAKER (UNDER PROFESSIONAL N)
Entity type:Individual
Prefix:MS
First Name:JANICE
Middle Name:BAKER
Last Name:SEIB
Suffix:
Gender:F
Credentials:UNDER PROFESSIONAL N
Other - Prefix:MS
Other - First Name:JANICE
Other - Middle Name:
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:1614 E. 17TH STREET
Mailing Address - Street 2:STE D
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705
Mailing Address - Country:US
Mailing Address - Phone:714-836-9900
Mailing Address - Fax:714-836-9090
Practice Address - Street 1:1614 E. 17TH STREET
Practice Address - Street 2:STE D
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705
Practice Address - Country:US
Practice Address - Phone:714-836-9900
Practice Address - Fax:714-836-9090
Is Sole Proprietor?:No
Enumeration Date:2010-01-05
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACAMFT45435106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist