Provider Demographics
NPI:1417833633
Name:NAVA, JOANNE (PPS 240115928)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:NAVA
Suffix:
Gender:F
Credentials:PPS 240115928
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18422 BEAR VALLEY RD BLDG 11
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-5850
Mailing Address - Country:US
Mailing Address - Phone:760-245-4262
Mailing Address - Fax:
Practice Address - Street 1:18422 BEAR VALLEY RD BLDG 11
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-5850
Practice Address - Country:US
Practice Address - Phone:760-245-4262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA240115928101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool