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General NPI Number Information
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NPI Number | 1982123543
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Entity Type | Individual
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Provider Name | JOANNE WILLIS LMFT
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Gender | Female
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Dates
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Enumeration Date | 09/14/2017
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 6 TARMAN DR
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City | CLOVERDALE
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State | CA
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Zip | 95425-3932
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Country | US
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Telephone | 707-894-4229
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Fax |
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Provider Business Mailing Address
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Address Line | 2655 HENLEY PKWY UNIT 511
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City | TRACY
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State | CA
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Zip | 95377-2214
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Country | US
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Telephone | 209-765-0950
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT120460
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License Number State | CA
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