Provider Demographics
NPI:1881178945
Name:NOVAC, JOANNA (LCSW)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:NOVAC
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 1:1400 QUAIL ST STE 210
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2761
Mailing Address - Country:US
Mailing Address - Phone:949-677-9146
Mailing Address - Fax:
Practice Address - Street 1:1400 QUAIL ST STE 210
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2761
Practice Address - Country:US
Practice Address - Phone:949-677-9147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-24
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA226011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical