Provider Demographics
NPI:1427295492
Name:PORTER, JOAN ALEXANDRA (MFT)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:ALEXANDRA
Last Name:PORTER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 ALAMEDA PADRE SERRA
Mailing Address - Street 2:STE 211
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-1761
Mailing Address - Country:US
Mailing Address - Phone:805-540-8555
Mailing Address - Fax:805-324-4913
Practice Address - Street 1:4444 CALLE REAL
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-1002
Practice Address - Country:US
Practice Address - Phone:805-681-4789
Practice Address - Fax:805-681-5239
Is Sole Proprietor?:No
Enumeration Date:2009-01-13
Last Update Date:2017-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT46392106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist