Provider Demographics
NPI:1679888010
Name:UDOVICH, JANET ANN
Entity type:Individual
Prefix:MS
First Name:JANET
Middle Name:ANN
Last Name:UDOVICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1511 OSOS STREET
Mailing Address - Street 2:C/O TRANSITIONS - MHA
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401
Mailing Address - Country:US
Mailing Address - Phone:805-541-0107
Mailing Address - Fax:805-544-0741
Practice Address - Street 1:784 HIGH STREET
Practice Address - Street 2:C/O TRANSITIONS - MHA
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401
Practice Address - Country:US
Practice Address - Phone:805-541-0107
Practice Address - Fax:805-544-0741
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health