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Individual

MRS. JANET MARIE CHUDACEK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
161 E MAIN ST, EL CAJON, CA 92020-3989
(619) 631-0153
Mailing address
161 E MAIN ST, EL CAJON, CA 92020-3989
(619) 631-0153

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
NP95008776
CA

Other

Enumeration date
04/12/2018
Last updated
05/07/2018
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