Provider Demographics
NPI:1447435342
Name:ECKMAN, JANIQUE ALLICE
Entity type:Individual
Prefix:
First Name:JANIQUE
Middle Name:ALLICE
Last Name:ECKMAN
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 1:700 H ST
Mailing Address - Street 2:APT. #2
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-1661
Mailing Address - Country:US
Mailing Address - Phone:925-726-6934
Mailing Address - Fax:
Practice Address - Street 1:700 H ST
Practice Address - Street 2:APT. #2
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-1661
Practice Address - Country:US
Practice Address - Phone:925-726-6934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)