Provider Demographics
NPI:1821578204
Name:DARE, JOANNA (PSYCHOLOGY BA)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:DARE
Suffix:
Gender:F
Credentials:PSYCHOLOGY BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1014 COTTAGE WAY
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-5857
Mailing Address - Country:US
Mailing Address - Phone:760-717-3321
Mailing Address - Fax:
Practice Address - Street 1:1014 COTTAGE WAY
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5857
Practice Address - Country:US
Practice Address - Phone:760-717-3321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-15
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health