Provider Demographics
NPI:1992085369
Name:WEISS, JANICE SUE (MFT)
Entity type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:SUE
Last Name:WEISS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20969 VENTURA BLVD
Mailing Address - Street 2:SUITE 214
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2305
Mailing Address - Country:US
Mailing Address - Phone:818-887-1066
Mailing Address - Fax:
Practice Address - Street 1:20969 VENTURA BLVD
Practice Address - Street 2:SUITE 214
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2305
Practice Address - Country:US
Practice Address - Phone:818-887-1066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-17
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37993106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist