Provider Demographics
NPI:1295845006
Name:STUBBLES, JOAN (MA)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:
Last Name:STUBBLES
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 RUBIS DR
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-1854
Mailing Address - Country:US
Mailing Address - Phone:408-736-5619
Mailing Address - Fax:408-736-5619
Practice Address - Street 1:835 RUBIS DR
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-1854
Practice Address - Country:US
Practice Address - Phone:408-736-5619
Practice Address - Fax:408-736-5619
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA021911101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health