Provider Demographics
NPI:1255475653
Name:CAIN, JOANNA DENISE (EDD ASSOCIATE)
Entity Type:Individual
Prefix:MS
First Name:JOANNA
Middle Name:DENISE
Last Name:CAIN
Suffix:
Gender:F
Credentials:EDD ASSOCIATE
Other - Prefix:DR
Other - First Name:JOANNA
Other - Middle Name:DENISE
Other - Last Name:CAIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:EDD
Mailing Address - Street 1:1820 W FLORENCE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90047-2123
Mailing Address - Country:US
Mailing Address - Phone:310-428-4152
Mailing Address - Fax:
Practice Address - Street 1:3200 LONG BEACH BLVD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-5062
Practice Address - Country:US
Practice Address - Phone:562-548-6565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-18
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA139344106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist