DR. JANICE MOORE PETTIS (NPI# 1619908852) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619908852 |
| Entity Type | Individual |
| Full Name | DR. JANICE MOORE PETTIS |
| Credential | PHD |
| Practice Address |
219 Estates Drive Suite 102 Roseville CA 95678-2391 |
| Practice Telephone | 9167869323 |
| Mailing Telephone | 9167869323 |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY11524 | CA | Behavioral Health & Social Service Providers |
| Street Address |
219 ESTATES DRIVE SUITE 102 |
| City | ROSEVILLE |
| State | CA |
| Zip Code | 95678-2391 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114533064 | Alexander V. Antipov, D.d.s., Inc. | Dentist | 911 Reserve Drive, Suite 150, Roseville, CA 95678 | 2020-09-16 |
| 1396378980 | David F Shirley M D P C | Family Medicine | 4001 Impala Circle, Roseville, CA 95678 | 2020-02-21 |
| 1083256051 | Rosemary Ellen Robben | Community Health Worker | Cirby Wellness Center 101 Cirby Hills Drive, Roseville, CA 95678 | 2019-10-11 |
| 1588217236 | Kaiser Foundation Health Plan Inc | Pharmacy | 1021 Riverside Ave, Roseville, CA 95678 | 2019-07-22 |
| 1174093793 | Neftali Hernandez | Behavior Technician | 1100 Roseville Parkway Apt 1021, Roseville, CA 95678 | 2018-11-26 |
| 1467951798 | Amarantha Martinez | Behavior Technician | 1900 Quail Ridge Road, #99, Roseville, CA 95678 | 2018-02-01 |
| 1093231276 | Compassionate Home Health, Ltd | Home Health | 1100 Melody Lane, Suite 106, Roseville, CA 95678 | 2017-08-18 |
| 1629598891 | Jimena Andrade Martins | Behavior Technician | 602 Atkinson Street, Roseville, CA 95678 | 2017-06-20 |
| 1891221057 | Zride Inc | Taxi | 106 Church Street, Suite 2, Roseville, CA 95678 | 2017-05-10 |
| 1568997641 | Joline Trinh | Pharmacist | 1030 Pleasant Grove Boulevard, Roseville, CA 95678 | 2017-04-26 |
| Find all providers in zip 95678 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205287885 | Layla Asamarai | Psychologist | 1611 County Road B W Ste 218, Roseville, MN 55113-4053 | 2016-06-25 |
| 1578939658 | Patricia L. Bach, Psyd, Inc., A Psychological Corporation | Psychologist | 300 Harding Blvd Ste 203k, Roseville, CA 95678-2474 | 2015-08-12 |
| 1760815229 | Tamarind P Knutson, LLC | Psychologist | 2579 Hamline Ave N Ste D, Roseville, MN 55113-3187 | 2013-08-19 |
| 1699021766 | Jazmine Mccoy | Psychologist | 8775 Sierra College Blvd Ste 250, Roseville, CA 95661-5986 | 2012-07-26 |
| 1437393287 | Kelly & Nguyen-kelly Psychological and Consulting Services, LLC | Psychologist | 1315 Larpenteur Ave W, Suite I, Roseville, MN 55113-6323 | 2009-04-23 |
| 1508087909 | Nicole Solomon | Psychologist | 1660 E Roseville Pkwy Ste 160, Roseville, CA 95661-3988 | 2007-05-01 |
| 1427273507 | Randy Allan Gilchrist I | Psychologist | 1899 E Roseville Pkwy Ste 100, Roseville, CA 95661-7980 | 2007-04-16 |
| 1033246137 | Heather Jane Forde | Psychologist | 970 Reserve Dr Ste 205, Roseville, CA 95678-1378 | 2007-02-27 |
| 1023159191 | Michael A. Molyn | Psychologist | Valley Psychological Center, 1891 E. Roseville Parkway, Suite 100, Roseville, CA 95661 | 2007-02-09 |
| 1427197540 | Travis H Owens | Psychologist | 1891 East Roseville Parkway, Suite 100, Roseville, CT 95661-7979 | 2007-02-05 |
| Find all providers in ROSEVILLE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.