Provider Demographics
NPI:1851933394
Name:HANN, JOANNE BEVERLY (LCSW)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:BEVERLY
Last Name:HANN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17391 REGALO LN
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-2039
Mailing Address - Country:US
Mailing Address - Phone:760-415-5054
Mailing Address - Fax:
Practice Address - Street 1:3505 CAMINO DEL RIO S STE 338
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-4017
Practice Address - Country:US
Practice Address - Phone:619-539-3775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-16
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW239161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical