Provider Demographics
NPI:1609801372
Name:FIELDS, JO ANN SHARON (MFT)
Entity Type:Individual
Prefix:MRS
First Name:JO ANN
Middle Name:SHARON
Last Name:FIELDS
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 1:6626 KENTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-3735
Mailing Address - Country:US
Mailing Address - Phone:818-884-4751
Mailing Address - Fax:818-884-4751
Practice Address - Street 1:25050 AVENUE KEARNY
Practice Address - Street 2:SUITE 101
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91355-1255
Practice Address - Country:US
Practice Address - Phone:818-884-7354
Practice Address - Fax:818-884-4751
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 37845106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist