Provider Demographics
NPI:1720896673
Name:LI, JANNY (LCSW)
Entity type:Individual
Prefix:
First Name:JANNY
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1831 SOLANO AVE
Mailing Address - Street 2:PO BOX 7574
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94707-0574
Mailing Address - Country:US
Mailing Address - Phone:626-456-1379
Mailing Address - Fax:
Practice Address - Street 1:1831 SOLANO AVE
Practice Address - Street 2:PO BOX 7574
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94707-0574
Practice Address - Country:US
Practice Address - Phone:626-456-1379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-24
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical