| Doctor Name: | JANICE STIMSON |
| NPI Number: | 1083824254 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D., R.A.S. |
| License Number: | S0504101451 |
| Business Practice Address: | 12304 Santa Monica Blvd Suite 200 West Los Angeles, CA - 900252551 |
| Business Phone Number: | 3102074322 |
| Business Fax Number: | 3102076511 |
| Mailing Address: | 12304 Santa Monica Blvd, Suite 200 WEST LOS ANGELES |
| State: | CA |
| Postal Code: | 900252551 |
| Phone Number: | 3102074322 |
| Fax Number: | 3102076511 |
| NPI Enumeration Date: | 05/23/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | S0504101451 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |