Provider Demographics
NPI:1225274988
Name:ZIEKE, JANICE
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:ZIEKE
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 1:1403 E CONCORD AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-3852
Mailing Address - Country:US
Mailing Address - Phone:714-287-6459
Mailing Address - Fax:562-981-2622
Practice Address - Street 1:850 E WARDLOW RD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-4628
Practice Address - Country:US
Practice Address - Phone:562-981-9392
Practice Address - Fax:562-981-2622
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-31
Last Update Date:2008-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALG130921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical