Provider Demographics
NPI:1043350697
Name:SHABANDAR, JOY LYNETTE (PHD, LPCC)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:LYNETTE
Last Name:SHABANDAR
Suffix:
Gender:F
Credentials:PHD, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22600 SAVI RANCH PKWY STE A3
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92887-4606
Mailing Address - Country:US
Mailing Address - Phone:918-261-5112
Mailing Address - Fax:
Practice Address - Street 1:22600 SAVI RANCH PKWY STE A3
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92887-4606
Practice Address - Country:US
Practice Address - Phone:918-261-5112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2998101YP2500X, 101YP2500X
TX10728101YA0400X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty