Individual
JILLIAN MARIE JANISEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ASW
Contact information
Practice address
621A 2ND ST, PETALUMA, CA 94952-5123
(707) 708-3090
Mailing address
PO BOX 2251, NAPA, CA 94558-0225
(415) 410-3393
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
ASW105244
CA
Other
Enumeration date
02/10/2022
Last updated
02/10/2022
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