Provider Demographics
NPI:1508604471
Name:MCBRIDE, JOANNA JUNE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:JUNE
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43391 CALLE CARABANA
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-3831
Mailing Address - Country:US
Mailing Address - Phone:951-775-1662
Mailing Address - Fax:
Practice Address - Street 1:43391 CALLE CARABANA
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-3831
Practice Address - Country:US
Practice Address - Phone:951-775-1662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-16
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA018380415101YA0400X
CALCSW1181081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)