Janette Baucham, LMFT

Individual provider Active NPI Marriage & Family Therapist · Pacoima, CA

NPI 1265664783 · NPPES record last updated Nov 18, 2020

Key facts

NPI
1265664783
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
MFC 54027 (CA)
Practice address
12450 Van Nuys Blvd Ste 100
Pacoima, CA 91331-1392
Phone
(818) 896-8366
NPI assigned
Aug 17, 2009
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MFC 54027CAMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC 54027 CA Yes

Addresses

Primary practice location

12450 Van Nuys Blvd Ste 100
Pacoima, CA 91331-1392

Mailing address

12450 Van Nuys Blvd Ste 100
Pacoima, CA 91331-1392

Other practice location 1

6851 Lennox Ave Ste 400
Van Nuys, CA 91405-4075
Phone (818) 989-9214

Other providers in Pacoima, CA

All providers in Pacoima, CA · Marriage & Family Therapist in California

Sources for this page

Verify at the official NPI Registry.