Provider Demographics
NPI:1033523873
Name:JOYCE EVANS LICENSED MARRIAGE FAMILY THERAPIST, INC.
Entity Type:Organization
Organization Name:JOYCE EVANS LICENSED MARRIAGE FAMILY THERAPIST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:GAYLE
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:626-339-2873
Mailing Address - Street 1:PO BOX 4191
Mailing Address - Street 2:750 TERRADO PLAZA SUITE 215, COVINA, CA 91723
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-0591
Mailing Address - Country:US
Mailing Address - Phone:626-339-2873
Mailing Address - Fax:626-915-5062
Practice Address - Street 1:750 TERRADO PLZ STE 215
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-3412
Practice Address - Country:US
Practice Address - Phone:626-339-2873
Practice Address - Fax:626-915-5062
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOYCE EVANS LICENSED MARRIAGE FAMILY THERAPIST, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-06-19
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC13881251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health