Provider Demographics
NPI:1497995898
Name:ROC, JOANNE JULIA (MFT)
Entity Type:Individual
Prefix:MISS
First Name:JOANNE
Middle Name:JULIA
Last Name:ROC
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 ORCHARD CITY DR
Mailing Address - Street 2:SUITE 170
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-2932
Mailing Address - Country:US
Mailing Address - Phone:408-341-3574
Mailing Address - Fax:
Practice Address - Street 1:1447 LINCOLN WAY
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-5008
Practice Address - Country:US
Practice Address - Phone:530-888-7958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-24
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT44635106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist