Provider Demographics
NPI:1730676206
Name:GROVES, JOANNE K (MFT INTERN)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:K
Last Name:GROVES
Suffix:
Gender:F
Credentials:MFT INTERN
Other - Prefix:
Other - First Name:JOANNE
Other - Middle Name:K
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1798 BRYMAN ST
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-7144
Mailing Address - Country:US
Mailing Address - Phone:559-679-3075
Mailing Address - Fax:
Practice Address - Street 1:1798 BRYMAN ST
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-7144
Practice Address - Country:US
Practice Address - Phone:559-679-3075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-19
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT104154101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health