Provider Demographics
NPI:1124322953
Name:DIONNE, JOAN
Entity type:Individual
Prefix:MS
First Name:JOAN
Middle Name:
Last Name:DIONNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2669
Mailing Address - Street 2:
Mailing Address - City:MURPHYS
Mailing Address - State:CA
Mailing Address - Zip Code:95247
Mailing Address - Country:US
Mailing Address - Phone:209-728-2422
Mailing Address - Fax:
Practice Address - Street 1:891 MOUNTAIN RANCH ROAD
Practice Address - Street 2:
Practice Address - City:SAN ANDREAS
Practice Address - State:CA
Practice Address - Zip Code:95249
Practice Address - Country:US
Practice Address - Phone:209-754-6525
Practice Address - Fax:209-754-6534
Is Sole Proprietor?:No
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker