Provider Demographics
NPI:1548272404
Name:CAIN, JANET S (PHD)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:S
Last Name:CAIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 TRANCAS ST STE 1B
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-2942
Mailing Address - Country:US
Mailing Address - Phone:707-255-6115
Mailing Address - Fax:707-255-6613
Practice Address - Street 1:935 TRANCAS ST STE 1B
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-2942
Practice Address - Country:US
Practice Address - Phone:707-255-6115
Practice Address - Fax:707-255-6613
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14516103G00000X, 103T00000X, 103TB0200X, 103TC2200X, 103TE1100X, 103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Not Answered103TE1100XBehavioral Health & Social Service ProvidersPsychologistExercise & Sports
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPL145160Medicare ID - Type UnspecifiedMEDICARE NUMBER