Individual provider Active NPI

Janice. Ann Tanner, PH.D.

  • Clinical Child & Adolescent Psychologist
  • Tacoma, WA
National Provider Identifier
1952387193
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
766 Issued in HI
Practice address
9040 Jackson Avenue
Tacoma, WA 98431-0001
Phone
(253) 967-2243
NPI assigned
Dec 20, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 766 HI Primary

Addresses

Primary practice location

9040 Jackson Avenue
Tacoma, WA 98431-0001

Mailing address

Unit 33100 Box Landstuhl
Apo, AE 09180-3100

Other practice location 1

Unit 33100 Box Landstuhl
Apo, AE 09180-3100
Phone (314) 590-1360

Other identifiers 1

IdentifierTypeStateIssuer
766OtherHIPSYCHOLOGIST

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
766HIMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1952387193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "UNIT 33100 BOX LANDSTUHL",
            "city": "APO",
            "state": "AE",
            "postal_code": "091803100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVENUE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-967-2243"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Unit 33100 Box Landstuhl",
            "address_purpose": "LOCATION",
            "city": "APO",
            "state": "AE",
            "postal_code": "091803100",
            "country_code": "US",
            "telephone_number": "314-590-1360",
            "country_name": "United States",
            "address_type": "MIL"
        }
    ],
    "basic": {
        "last_name": "TANNER",
        "first_name": "JANICE.",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-20",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "HI",
            "license": "766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGIST",
            "identifier": "766",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.