Joan Hennes

Individual provider Active NPI Clinical Social Worker · Exeter, CA

NPI 1457548273 · NPPES record last updated Sep 25, 2007

Key facts

NPI
1457548273
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
22788 (CA)
Practice address
1014 San Juan Ave
Exeter, CA 93221-1312
Phone
(559) 592-7300
Fax
(559) 594-4631
NPI assigned
Sep 25, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
22788CAMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 22788 CA Yes

Addresses

Primary practice location

1014 San Juan Ave
Exeter, CA 93221-1312

Mailing address

1014 San Juan Ave
Exeter, CA 93221-1312
Phone (559) 592-7300

Other providers in Exeter, CA

All providers in Exeter, CA · Clinical Social Worker in California

Sources for this page

Verify at the official NPI Registry.