Provider Demographics
NPI:1942217773
Name:POWERS, JOAN (MFT)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:POWERS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:
Other - Last Name:POWERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:117 TULLOCK CT.
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-6488
Mailing Address - Country:US
Mailing Address - Phone:916-221-2027
Mailing Address - Fax:916-221-2027
Practice Address - Street 1:5701 LONETREE BLVD
Practice Address - Street 2:SUITE 216
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-3772
Practice Address - Country:US
Practice Address - Phone:916-221-2027
Practice Address - Fax:916-221-2027
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC30087106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6532OtherMEDICAL SACRAMENTO COUNTY