Provider Demographics
NPI:1003020371
Name:ULOFOSHIO, JOYCE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:
Last Name:ULOFOSHIO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:JOYCE
Other - Middle Name:
Other - Last Name:ULOFOSHIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:3067 E WARM SPRINGS RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-3750
Mailing Address - Country:US
Mailing Address - Phone:702-202-0000
Mailing Address - Fax:
Practice Address - Street 1:3067 E WARM SPRINGS RD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120
Practice Address - Country:US
Practice Address - Phone:702-907-6521
Practice Address - Fax:702-710-6521
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY0941103TC0700X
AK257535171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK100103Medicaid
AKCMG447Medicaid