Doctor Name: | MRS. JUANA C ANTHENIEN |
NPI Number: | 1235377573 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 1137 Emerald Bay Rd South Lake Tahoe, CA - 961506207 |
Business Phone Number: | 5305415190 |
Business Fax Number: | 5305416031 |
Mailing Address: | 1137 Emerald Bay Rd, SOUTH LAKE TAHOE |
State: | CA |
Postal Code: | 961506207 |
Phone Number: | 5305415190 |
Fax Number: | 5305416031 |
NPI Enumeration Date: | 01/23/2009 |
NPI Last Update Date: | 01/23/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |