Provider Demographics
NPI:1902401698
Name:FLEMING LOYARTE, JOANNE LEE (MS)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:LEE
Last Name:FLEMING LOYARTE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 853
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92822-0853
Mailing Address - Country:US
Mailing Address - Phone:562-879-7996
Mailing Address - Fax:
Practice Address - Street 1:136 S IMPERIAL HWY
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-3943
Practice Address - Country:US
Practice Address - Phone:562-879-7996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-01
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA120366106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist