Provider Demographics
NPI:1114156494
Name:NOAR, JOHNINA (CAADAC)
Entity Type:Individual
Prefix:
First Name:JOHNINA
Middle Name:
Last Name:NOAR
Suffix:
Gender:F
Credentials:CAADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 VIA CHICA CT
Mailing Address - Street 2:
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-1721
Mailing Address - Country:US
Mailing Address - Phone:858-481-2191
Mailing Address - Fax:
Practice Address - Street 1:130 S FIG ST
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4401
Practice Address - Country:US
Practice Address - Phone:760-741-5098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-08
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAI8469503101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)