Provider Demographics
NPI:1114151222
Name:PAYNTER, JOANNA MARIE
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:MARIE
Last Name:PAYNTER
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 1:3100 S. HARBOR BLVD. STE200
Mailing Address - Street 2:
Mailing Address - City:SANTA AN
Mailing Address - State:CA
Mailing Address - Zip Code:92704
Mailing Address - Country:US
Mailing Address - Phone:714-966-8650
Mailing Address - Fax:
Practice Address - Street 1:3100 S. HARBOR BLVD. STE200
Practice Address - Street 2:
Practice Address - City:SANTA AN
Practice Address - State:CA
Practice Address - Zip Code:92704
Practice Address - Country:US
Practice Address - Phone:714-966-8650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-05
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist