Individual
JANICE IVIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
941 MERCHANT ST STE A, VACAVILLE, CA 95688-5315
(707) 628-4140
Mailing address
PO BOX 6601, VACAVILLE, CA 95696-6601
(707) 249-6898
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
493762
CA
163WP0808X
Psychiatric/Mental Health Registered Nurse
NPF95001148
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95001148
CA
Other
Enumeration date
08/29/2013
Last updated
07/11/2024
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