Provider Demographics
NPI:1073896403
Name:MATZEN, JOYCE JEAN (PHARMD,MS)
Entity Type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:JEAN
Last Name:MATZEN
Suffix:
Gender:F
Credentials:PHARMD,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:485 JEFFERSON DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT SHASTA
Mailing Address - State:CA
Mailing Address - Zip Code:96067-9229
Mailing Address - Country:US
Mailing Address - Phone:530-918-9337
Mailing Address - Fax:530-918-9337
Practice Address - Street 1:1775 EUREKA WAY
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-0456
Practice Address - Country:US
Practice Address - Phone:530-241-3294
Practice Address - Fax:530-241-7262
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28790183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist