Provider Demographics
NPI:1992381206
Name:GIVEN, JANA MARIE (PSYD)
Entity type:Individual
Prefix:DR
First Name:JANA
Middle Name:MARIE
Last Name:GIVEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 6TH ST STE 101A-187
Mailing Address - Street 2:
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-1472
Mailing Address - Country:US
Mailing Address - Phone:949-422-8125
Mailing Address - Fax:
Practice Address - Street 1:960 6TH ST STE 101A-187
Practice Address - Street 2:
Practice Address - City:NORCO
Practice Address - State:CA
Practice Address - Zip Code:92860-1472
Practice Address - Country:US
Practice Address - Phone:949-422-8125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY29295103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist