Healthcare Provider Details
I. General information
NPI: 1982911210
Provider Name (Legal Business Name): JOANNE RACHELLE OWINGS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/08/2010
Last Update Date: 06/11/2024
Certification Date: 06/11/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5201 GREAT AMERICA PKWY STE 320
SANTA CLARA CA
95054-1140
US
IV. Provider business mailing address
30777 RANCHO CALIFORNIA RD # 890361
TEMECULA CA
92591-3209
US
V. Phone/Fax
- Phone: 323-205-7088
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 80762 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: