Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PSY12436 | CA |
Y | 103T00000X | Psychologist | PSY12436 | CA |
NPI | 1003970427 |
---|---|
Provider Name | Dr. Janice Marie Schreckengost |
First Address | Redwood City, CA 94063-1499 |
Second Address | Redwood City, CA 94063-1499 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2006 |
Last Update Date | 01/04/2014 |